Provider Demographics
NPI:1801164926
Name:SCHULTZ, ALBA (NP)
Entity type:Individual
Prefix:
First Name:ALBA
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1115 SE 164TH AVE DEPT 358
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-8004
Mailing Address - Country:US
Mailing Address - Phone:360-729-1253
Mailing Address - Fax:360-729-3185
Practice Address - Street 1:2846 WILLAMETTE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405
Practice Address - Country:US
Practice Address - Phone:541-222-8700
Practice Address - Fax:541-222-8701
Is Sole Proprietor?:No
Enumeration Date:2011-12-03
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP61500987363LF0000X
IDNP1123A363LX0001X
OR201393041NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500664033Medicaid