Provider Demographics
NPI:1821583147
Name:SCHOESSLER, DOMINIQUE MUGUET
Entity Type:Individual
Prefix:MS
First Name:DOMINIQUE
Middle Name:MUGUET
Last Name:SCHOESSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DOMINIQUE
Other - Middle Name:
Other - Last Name:GERMAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4080 REED RD SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1357
Mailing Address - Country:US
Mailing Address - Phone:503-581-1732
Mailing Address - Fax:503-363-4607
Practice Address - Street 1:4080 REED RD SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1357
Practice Address - Country:US
Practice Address - Phone:503-581-1732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator