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General NPI Number Information
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NPI Number | 1255464772
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Entity Type | Individual
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Provider Name | JO ELLEN SCHOBLOM BSN,MS, WHCNP
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4855 SW WESTERN AVE
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City | BEAVERTON
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State | OR
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Zip | 97005-3460
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Country | US
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Telephone | 503-520-4893
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Fax |
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Provider Business Mailing Address
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Address Line | 7546 SW ALOMA WAY # 6
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City | PORTLAND
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State | OR
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Zip | 97223-7929
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Country | US
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Telephone | 503-452-8762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 075034762N7
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License Number State | OR
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