Basic Information
| Provider Information | |||||||||
| NPI: | 1457430431 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHMIDT | ||||||||
| FirstName: | RAINER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2250 NW FLANDERS ST STE 205 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972105410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032233104 | ||||||||
| FaxNumber: | 5032234619 | ||||||||
| Practice Location | |||||||||
| Address1: | 2250 NW FLANDERS ST STE 205 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972105410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032233104 | ||||||||
| FaxNumber: | 5032234619 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 12881 | OR | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.