Provider Demographics
NPI:1700957818
Name:SCHULLER, ROSEMARY FRANCES (LMT)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:FRANCES
Last Name:SCHULLER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ROMY
Other - Middle Name:
Other - Last Name:SCHULLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4135 NE ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2911
Mailing Address - Country:US
Mailing Address - Phone:503-819-2911
Mailing Address - Fax:
Practice Address - Street 1:2100 NE BROADWAY ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1569
Practice Address - Country:US
Practice Address - Phone:503-287-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11203225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist