Provider Demographics
NPI:1609965474
Name:SCHREYER, DARRELL M (DC)
Entity type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:M
Last Name:SCHREYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11801 NE 160TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011
Mailing Address - Country:US
Mailing Address - Phone:425-488-3477
Mailing Address - Fax:425-481-8031
Practice Address - Street 1:11801 NE 160TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011
Practice Address - Country:US
Practice Address - Phone:425-488-3477
Practice Address - Fax:425-481-8031
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2632111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU47740Medicare UPIN
WAAB20570Medicare ID - Type Unspecified
WAGAB20570Medicare UPIN