Provider Demographics
NPI:1053826024
Name:SCHAUB, PHILIP (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:SCHAUB
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 SW 4TH AVE APT 413
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5533
Mailing Address - Country:US
Mailing Address - Phone:614-315-3130
Mailing Address - Fax:
Practice Address - Street 1:1720 SW 4TH AVE APT 413
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5533
Practice Address - Country:US
Practice Address - Phone:614-315-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4645225100000X
AZ11993225100000X
CA43486225100000X
WACP012029T225100000X
OR63693225100000X
OHPT015341225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist