Provider Demographics
NPI:1821483603
Name:SCHNACK, JONATHAN (RDCS RVT RCS RVS RPH)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:SCHNACK
Suffix:
Gender:M
Credentials:RDCS RVT RCS RVS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97308-0008
Mailing Address - Country:US
Mailing Address - Phone:971-239-9027
Mailing Address - Fax:
Practice Address - Street 1:1776 OLD MIDDLEFIELD WAY UPPR HEALTH
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-1809
Practice Address - Country:US
Practice Address - Phone:971-239-9027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography