Provider Demographics
NPI:1346464906
Name:SCHMUNK, NATHAN WILLIAM (DPT)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:WILLIAM
Last Name:SCHMUNK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5848 MOOSEBERRY CT SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-9845
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4132 DEVONSHIRE CT NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1982
Practice Address - Country:US
Practice Address - Phone:503-364-5313
Practice Address - Fax:503-364-5296
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60236225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist