Basic Information
| Provider Information | |||||||||
| NPI: | 1851572630 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHMIDT | ||||||||
| FirstName: | BRUCE | ||||||||
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| Credential: | BC-HIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8800 SE SUNNYSIDE RD. | ||||||||
| Address2: | STE. 300-N | ||||||||
| City: | CLACKAMAS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970155738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036595115 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2470 PATERSON RD. | ||||||||
| Address2: | STE. 10 | ||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815051028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702427664 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2007 | ||||||||
| LastUpdateDate: | 06/06/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 91 | CO | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237700000X | 137 | CO | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.