Healthcare Provider Details

I. General information

NPI: 1790864858
Provider Name (Legal Business Name): JAMES B SCHADER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19875 SW 65TH AVE SUITE 201
TUALATIN OR
97062-8353
US

IV. Provider business mailing address

19875 SW 65TH AVE SUITE 201
TUALATIN OR
97062-8353
US

V. Phone/Fax

Practice location:
  • Phone: 503-692-3250
  • Fax: 503-691-2212
Mailing address:
  • Phone: 503-692-3250
  • Fax: 503-691-2212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD13240
License Number StateOR

VIII. Authorized Official

Name: DR. JAMES B SCHADER
Title or Position: CORPORATE PRESIDENT
Credential: MD
Phone: 503-692-3250