Healthcare Provider Details

I. General information

NPI: 1790802569
Provider Name (Legal Business Name): REED JAY SCHEMINSKE LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3863 SW HALL BLVD SUITE B
BEAVERTON OR
97005-2049
US

IV. Provider business mailing address

3863 SW HALL BLVD SUITE B
BEAVERTON OR
97005-2049
US

V. Phone/Fax

Practice location:
  • Phone: 503-626-4242
  • Fax: 503-626-4242
Mailing address:
  • Phone: 503-626-4242
  • Fax: 503-626-4242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7099
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: