MEDICARE: CRISTINA SCHNIDER O.D.

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	152WC0802X	Corneal and Contact Management Optometrist	1726T	OR
2	152W00000X	Optometrist	ATI1726	OR

General Provider Information

NPI Number	:	1730572744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA SCHNIDER O.D.

Provider Business Mailing Address
First Line	:	19901 NE 153RD CIR
Second Line	:
City	:	BRUSH PRAIRIE
State	:	WA
Zip	:	98606-5225
Country	:	US
Telephone Number	:	904-614-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2043 COLLEGE WAY
Second Line	:
City	:	FOREST GROVE
State	:	OR
Zip	:	97116-1797
Country	:	US
Telephone Number	:	904-614-6100
Fax Number	:

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

Provider Enumeration Date	:	03/16/2015
Last Update Date	:	09/02/2020

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