Healthcare Provider Details

I. General information

NPI: 1508470915
Provider Name (Legal Business Name): DAN SCHMITT THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 WILLAMETTE ST STE 301
EUGENE OR
97401-2692
US

IV. Provider business mailing address

541 WILLAMETTE ST STE 301
EUGENE OR
97401-2692
US

V. Phone/Fax

Practice location:
  • Phone: 541-632-3790
  • Fax:
Mailing address:
  • Phone: 541-632-3790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier500782325
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name: DAN THOMAS SCHMITT
Title or Position: OWNER
Credential: MFT
Phone: 541-632-3790