MEDICARE: CRIS ANN SCHOENBAUER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	61468	OR

General Provider Information

NPI Number	:	1639827322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRIS ANN SCHOENBAUER DPT

Provider Business Mailing Address
First Line	:	6410 NE HALSEY ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97213-4742
Country	:	US
Telephone Number	:	503-215-4646
Fax Number	:

Provider Business Practice Location Address
First Line	:	10120 SW PARK WAY
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97225-5008
Country	:	US
Telephone Number	:	503-215-4646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2022
Last Update Date	:	03/12/2022

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Directions to “ CRIS ANN SCHOENBAUER DPT” Practice Location

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