Provider Demographics
NPI:1679784565
Name:SCHAEFER, MADELINE CATHERINE (CNM, ND)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:CATHERINE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:CNM, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 SE MAIN ST STE 3001
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2458
Mailing Address - Country:US
Mailing Address - Phone:503-261-4423
Mailing Address - Fax:503-261-4424
Practice Address - Street 1:10101 SE MAIN ST STE 3001
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2458
Practice Address - Country:US
Practice Address - Phone:503-261-4423
Practice Address - Fax:503-261-4424
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0583175F00000X
WAAP30007172367A00000X
OR200550125NP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR012703Medicare ID - Type UnspecifiedND