1932422219 NPI number — REBEKAH ANN SCHIEFER MSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932422219 NPI number — REBEKAH ANN SCHIEFER MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHIEFER
Provider First Name:
REBEKAH
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932422219
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1234
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT HELENS
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97051-8234
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-397-5211
Provider Business Mailing Address Fax Number:
503-397-5373

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
58646 MCNULTY WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT HELENS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97051-6210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-397-5211
Provider Business Practice Location Address Fax Number:
503-397-5373
Provider Enumeration Date:
03/01/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 123190 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com