Provider Demographics
NPI:1134795073
Name:SCHIEDLER, MARYJANE
Entity type:Individual
Prefix:
First Name:MARYJANE
Middle Name:
Last Name:SCHIEDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 E FERNWOOD RD APT 803
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-7160
Mailing Address - Country:US
Mailing Address - Phone:503-608-2579
Mailing Address - Fax:
Practice Address - Street 1:3355 E FERNWOOD RD APT 803
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-7160
Practice Address - Country:US
Practice Address - Phone:503-608-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty