NPI 1003208638

Vickey Schmadeka

Practitioner Contractor Boise, ID

Practice location

Address: 8565 W Stonehaven St, Boise, ID 83704-7079
Phone: (541) 805-0028

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence MAS-2130 (ID)

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Registry record

NPI: 1003208638
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Feb 2015
Record last updated: 18 Feb 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.