Provider Demographics
NPI:1255338273
Name:SCHMALTZ, KIM LOREN (ND, DC)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:LOREN
Last Name:SCHMALTZ
Suffix:
Gender:M
Credentials:ND, DC
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 2086
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-2086
Mailing Address - Country:US
Mailing Address - Phone:503-855-3244
Mailing Address - Fax:503-855-3597
Practice Address - Street 1:8855 SW HOLLY LANE
Practice Address - Street 2:SUITE 105
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070
Practice Address - Country:US
Practice Address - Phone:503-855-3244
Practice Address - Fax:503-855-3597
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273050111N00000X
OR3050111N00000X
OR1224175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No111N00000XChiropractic ProvidersChiropractor