Individual
MRS. TRACI D SCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
110 TIBBETTS DR, PONDERAY, ID 83852-9812
(208) 255-7337
(208) 561-9705
Mailing address
1221 MICHIGAN ST, SANDPOINT, ID 83864-1745
(208) 255-6693
(208) 265-0875
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT1518
ID
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010137720
BLUE SHIELD
ID
05
—
3400170
—
MT
05
—
7122757
—
WA
05
—
806157500
—
ID
01
—
T7374
BLUE CROSS
ID
Enumeration date
10/11/2006
Last updated
06/13/2023
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