Provider Demographics
NPI:1730639626
Name:SCHMIDT, CAMERON M (PA-C)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:M
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PROFESSIONAL BUILDING TWO 10101 SE MAIN STREET
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216
Mailing Address - Country:US
Mailing Address - Phone:503-346-1500
Mailing Address - Fax:503-346-1501
Practice Address - Street 1:10101 SE MAIN ST STE 1001
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2456
Practice Address - Country:US
Practice Address - Phone:503-346-1500
Practice Address - Fax:503-346-1501
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60698219363A00000X
ORPA206168363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant