Healthcare Provider Details

I. General information

NPI: 1164866885
Provider Name (Legal Business Name): SEAN SCHULZ D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36860 INDUSTRIAL WAY
SANDY OR
97055-7371
US

IV. Provider business mailing address

PO BOX 3777
PORTLAND OR
97208-3777
US

V. Phone/Fax

Practice location:
  • Phone: 503-826-0206
  • Fax: 503-826-0216
Mailing address:
  • Phone: 503-413-3900
  • Fax: 503-413-3710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO177922
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: