Basic Information
| Provider Information | |||||||||
| NPI: | 1225224272 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHREITZ | ||||||||
| FirstName: | NAN | ||||||||
| MiddleName: | BRYAN | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3727 NE MARTIN LUTHER KING JR BLVD | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972121112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5037754931 | ||||||||
| FaxNumber: | 5037887285 | ||||||||
| Practice Location | |||||||||
| Address1: | 3231 SE 50TH AVE | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972062248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5037754931 | ||||||||
| FaxNumber: | 5037887285 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2007 | ||||||||
| LastUpdateDate: | 12/04/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 200750126NP | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 9655929 | 05 | WA | MEDICAID | 278883 | 05 | OR | MEDICAID |