Healthcare Provider Details

I. General information

NPI: 1275115537
Provider Name (Legal Business Name): G SCHNEPPER DDS MS - OREGON PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4707 NE TILLAMOOK ST
PORTLAND OR
97213-2057
US

IV. Provider business mailing address

4707 NE TILLAMOOK ST
PORTLAND OR
97213-2057
US

V. Phone/Fax

Practice location:
  • Phone: 503-287-9710
  • Fax: 503-281-7098
Mailing address:
  • Phone: 503-287-9710
  • Fax: 503-281-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMI BARLOW
Title or Position: OFFICE MANAGER
Credential:
Phone: 503-287-9710