Healthcare Provider Details

I. General information

NPI: 1134133184
Provider Name (Legal Business Name): KATHRYN MARIE SCHWAB MPH, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5211 NE GLISAN ST BLDG C
PORTLAND OR
97213-3052
US

IV. Provider business mailing address

9986 SE 134TH AVE
HAPPY VALLEY OR
97236-5958
US

V. Phone/Fax

Practice location:
  • Phone: 503-215-6605
  • Fax: 503-215-6240
Mailing address:
  • Phone: 503-215-6605
  • Fax: 503-215-6240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: