Provider Demographics
NPI:1003871807
Name:SCHRATTENHOLZER, THOMAS F (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:SCHRATTENHOLZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 NW 22ND AVE STE 345
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2978
Mailing Address - Country:US
Mailing Address - Phone:503-413-7513
Mailing Address - Fax:503-413-7503
Practice Address - Street 1:1130 NW 22ND AVE STE 345
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2978
Practice Address - Country:US
Practice Address - Phone:503-413-7513
Practice Address - Fax:503-413-7503
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25109207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR277899Medicaid
ORP00199980OtherRR MEDICARE
WA8416463Medicaid
WA8416463Medicaid
I15087Medicare UPIN
OR130472Medicare PIN