Provider Demographics
NPI:1114351897
Name:SCHECKMANN, EDUARD
Entity Type:Individual
Prefix:
First Name:EDUARD
Middle Name:
Last Name:SCHECKMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11795 SW TUALATIN RD APT 35
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-7095
Mailing Address - Country:US
Mailing Address - Phone:503-473-7368
Mailing Address - Fax:
Practice Address - Street 1:9009 SW HALL BLVD
Practice Address - Street 2:T-0345
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-4432
Practice Address - Country:US
Practice Address - Phone:503-624-0273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0013752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist