Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 1707 | AK |
N | 207Q00000X | Family Doctor | MD158400 | OR |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD158400 | OR |
N | 207R00000X | Internist | MD158400 | OR |
N | 111NI0900X | Internist | MD158400 | OR |
NPI | 1225040157 |
---|---|
Provider Name | John H Schwartz |
First Address | Portland, OR 97208-3158 |
Second Address | Tigard, OR 97224-7259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 24/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E33740 | (02) | |
P00168125 | RAILROAD MEDICARE PIN# (01) | AK |