Provider Demographics
NPI:1679714299
Name:SCHWAB, JEFFERY DUANE (FNP)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:DUANE
Last Name:SCHWAB
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 PAGE ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-5097
Mailing Address - Country:US
Mailing Address - Phone:503-365-9752
Mailing Address - Fax:
Practice Address - Street 1:875 OAK ST SE STE 4030
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3984
Practice Address - Country:US
Practice Address - Phone:503-561-6444
Practice Address - Fax:503-561-6442
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR097006731RN163WX0200X
OR201050004NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0200XNursing Service ProvidersRegistered NurseOncology