Healthcare Provider Details

I. General information

NPI: 1841668027
Provider Name (Legal Business Name): MICHELLE ELIZABETH SCHIMPKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2015
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6605 SE LAKE RD
PORTLAND OR
97222-2161
US

IV. Provider business mailing address

2051 KAEN RD
OREGON CITY OR
97045-4035
US

V. Phone/Fax

Practice location:
  • Phone: 503-655-8401
  • Fax:
Mailing address:
  • Phone: 971-997-0409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberL16243
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL16243
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: