Provider Demographics
NPI:1811050537
Name:SCHARER, NICOLE MARIE (DC)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARIE
Last Name:SCHARER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:KREBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1755 SOUTHWIND CIR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97121-1204
Mailing Address - Country:US
Mailing Address - Phone:207-577-0821
Mailing Address - Fax:
Practice Address - Street 1:3250 LEIF ERIKSON DR
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103
Practice Address - Country:US
Practice Address - Phone:503-338-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2018-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1689111N00000X
ORRPH0015506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No111N00000XChiropractic ProvidersChiropractor