Provider Demographics
NPI:1003177106
Name:SCHULER, ELIZABETH FREDA (DMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:FREDA
Last Name:SCHULER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 NE 181ST AVE STE C
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-6664
Mailing Address - Country:US
Mailing Address - Phone:502-608-2076
Mailing Address - Fax:
Practice Address - Street 1:202 NE 181ST AVE STE C
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-6664
Practice Address - Country:US
Practice Address - Phone:503-912-0443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8207122300000X, 1223G0001X
ORD114781223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX8207Medicaid