Provider Demographics
NPI:1578819561
Name:SCHAALMA, LYNELLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LYNELLE
Middle Name:
Last Name:SCHAALMA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 SNIDOW DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4342
Mailing Address - Country:US
Mailing Address - Phone:503-347-3337
Mailing Address - Fax:
Practice Address - Street 1:1020 SNIDOW DR
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4342
Practice Address - Country:US
Practice Address - Phone:503-347-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200541754RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR460572493OtherEIN