Provider Demographics
NPI:1255388658
Name:SCHNEIDERHAN, DANIEL ANTHONY (OD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ANTHONY
Last Name:SCHNEIDERHAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 WILLAMETTE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405
Mailing Address - Country:US
Mailing Address - Phone:541-683-3744
Mailing Address - Fax:541-683-6672
Practice Address - Street 1:2460 WILLAMETTE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3169
Practice Address - Country:US
Practice Address - Phone:541-683-3744
Practice Address - Fax:541-683-6672
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1875T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR006432Medicaid
OR006432Medicaid
ORT40038Medicare UPIN