Healthcare Provider Details

I. General information

NPI: 1770561631
Provider Name (Legal Business Name): ANDREW CHESTER SCHINK D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2006
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 CHAMBERS ST SUITE 201
EUGENE OR
97402-3655
US

IV. Provider business mailing address

1680 CHAMBERS ST SUITE 201
EUGENE OR
97402-3655
US

V. Phone/Fax

Practice location:
  • Phone: 541-683-3351
  • Fax: 541-683-6440
Mailing address:
  • Phone: 541-683-3351
  • Fax: 541-683-6440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberDP00122
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier058685
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: