Provider Demographics
NPI:1053030940
Name:SCHRADER, JAMES CLINTON JR (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CLINTON
Last Name:SCHRADER
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 BROADWAY E APT 226
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-5373
Mailing Address - Country:US
Mailing Address - Phone:206-399-7598
Mailing Address - Fax:
Practice Address - Street 1:8867 161ST AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3585
Practice Address - Country:US
Practice Address - Phone:425-869-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61324681183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist