Provider Demographics
NPI:1700030483
Name:SCHMIERBACH, ANGELA KATHLEEN (RDH)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:KATHLEEN
Last Name:SCHMIERBACH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 SE JOHNSON CREEK BLVD APT C304
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97086-3674
Mailing Address - Country:US
Mailing Address - Phone:503-913-8821
Mailing Address - Fax:
Practice Address - Street 1:9701 SE JOHNSON CREEK BLVD APT C304
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97086-3674
Practice Address - Country:US
Practice Address - Phone:503-913-8821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH5520124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist