Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | MD25109 | OR |
NPI | 1003871807 |
---|---|
Provider Name | Dr. Thomas F Schrattenholzer |
First Address | Portland, OR 97210-2978 |
Second Address | Portland, OR 97210-2978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 08/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
277899 | (05) | OR |
8416463 | (05) | WA |
I15087 | (02) | |
P00199980 | RR MEDICARE (01) | OR |