Individual
KRISTEN SCHMIEDESKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4314
(503) 346-6810
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4314
(503) 346-6810
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA162371
OR
363A00000X
Physician Assistant
PA22177
CA
363AS0400X
Surgical Physician Assistant
Primary
PA162371
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500656078
—
OR
01
—
P01353883
RR MEDICARE - PHS
OR
Enumeration date
03/12/2012
Last updated
02/11/2022
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