Healthcare Provider Details

I. General information

NPI: 1821031352
Provider Name (Legal Business Name): ALLISON H SCHMIDT M.A., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

761 GOLF VIEW DR SUITE C
MEDFORD OR
97504-9655
US

IV. Provider business mailing address

761 GOLF VIEW DR SUITE C
MEDFORD OR
97504-9655
US

V. Phone/Fax

Practice location:
  • Phone: 541-779-9654
  • Fax: 541-245-3114
Mailing address:
  • Phone: 541-779-9654
  • Fax: 541-245-3114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number22249
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: