Healthcare Provider Details

I. General information

NPI: 1750179172
Provider Name (Legal Business Name): TYLER SCHMIDT RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7815 N HUDSON ST
PORTLAND OR
97203-3116
US

IV. Provider business mailing address

7815 N HUDSON ST
PORTLAND OR
97203-3116
US

V. Phone/Fax

Practice location:
  • Phone: 509-991-7250
  • Fax:
Mailing address:
  • Phone: 509-991-7250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN61302240
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number202213493RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: