Provider Demographics
NPI:1477799500
Name:SCHMIDTGALL, KRISTIN KIMMEL (MPH, MPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:KIMMEL
Last Name:SCHMIDTGALL
Suffix:
Gender:F
Credentials:MPH, MPAS, PA-C
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:KIMMEL
Other - Last Name:DUNLAP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH, MPAS, PA-C
Mailing Address - Street 1:3207 SW PERKINS AVE
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-4465
Mailing Address - Country:US
Mailing Address - Phone:541-276-4642
Mailing Address - Fax:541-276-4975
Practice Address - Street 1:3207 SW PERKINS AVE
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-4465
Practice Address - Country:US
Practice Address - Phone:541-215-1564
Practice Address - Fax:541-215-1567
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR150100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant