=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427209006
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES F SCHMIDT MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2008
-----------------------------------------------------
Last Update Date | 02/02/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5050 NE HOYT ST STE 611
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97213-2990
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-215-0855
-----------------------------------------------------
Fax | 503-215-0839
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5050 NE HOYT ST STE 611
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97213-2990
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-215-0855
-----------------------------------------------------
Fax | 503-215-0839
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACCOUNTS PAYABLE
-----------------------------------------------------
Name | DONNA THOMSEN
-----------------------------------------------------
Credential | R.N.
-----------------------------------------------------
Telephone | 503-215-0855
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | MD07616
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------