MEDICARE: JAMES M SCHROEDER P.A.

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	363A00000X	Physician Assistant	PA-185	ID
2	363A00000X	Physician Assistant	PA154561	OR

General Provider Information

NPI Number	:	1780630202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES M SCHROEDER P.A.

Provider Business Mailing Address
First Line	:	798 EASTLAND DR
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-6856
Country	:	US
Telephone Number	:	208-734-3312
Fax Number	:	208-734-3313

Provider Business Practice Location Address
First Line	:	3036 NE MLK JR BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212-3053
Country	:	US
Telephone Number	:	503-283-3763
Fax Number	:

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	09/18/2023

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Directions to “ JAMES M SCHROEDER P.A.” Practice Location

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