MEDICARE: PHILIP SCHAUB PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	4645	NM
2	225100000X	Physical Therapist	11993	AZ
3	225100000X	Physical Therapist	43486	CA
4	225100000X	Physical Therapist	CP012029T	WA
5	225100000X	Physical Therapist	63693	OR
6	225100000X	Physical Therapist	PT015341	OH

General Provider Information

NPI Number	:	1053826024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP SCHAUB PT, DPT

Provider Business Mailing Address
First Line	:	1720 SW 4TH AVE APT 413
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97201-5533
Country	:	US
Telephone Number	:	614-315-3130
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 SW 4TH AVE APT 413
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97201-5533
Country	:	US
Telephone Number	:	614-315-3130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2017
Last Update Date	:	07/13/2022

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