Basic Information
Provider Information
NPI: 1316172943
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOOLER
FirstName: TODD
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 421 SW OAK ST
Address2: 520
City: PORTLAND
State: OR
PostalCode: 972041817
CountryCode: US
TelephoneNumber: 5035224858
FaxNumber: 5039885870
Practice Location
Address1: 421 SW OAK ST
Address2: 520
City: PORTLAND
State: OR
PostalCode: 972041817
CountryCode: US
TelephoneNumber: 5035224858
FaxNumber: 5039885870
Other Information
ProviderEnumerationDate: 05/27/2009
LastUpdateDate: 01/06/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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