Provider Demographics
NPI:1356485734
Name:SCHRADER-PATTON, LINDA JANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JANE
Last Name:SCHRADER-PATTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:J
Other - Last Name:SCHRADER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:731 NW FRANKLIN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2752
Mailing Address - Country:US
Mailing Address - Phone:541-419-3949
Mailing Address - Fax:
Practice Address - Street 1:731 NW FRANKLIN AVE STE 103
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2752
Practice Address - Country:US
Practice Address - Phone:541-419-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1489103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical