1437250057 NPI number — MARGUERITTE MARTHA SCHLEINITZ NP

Table of content: MARGUERITTE MARTHA SCHLEINITZ NP (NPI 1437250057)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437250057 NPI number — MARGUERITTE MARTHA SCHLEINITZ NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHLEINITZ
Provider First Name:
MARGUERITTE
Provider Middle Name:
MARTHA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
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:
1437250057
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4013 ABBY LN NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVERTON
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97381-9278
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-873-3786
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5125 SKYLINE RD S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97306-9427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-361-5400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2006

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: 363LP0808X , with the licence number:  OR 000036320N6 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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