Provider Demographics
NPI:1205326584
Name:SCHOONOVER, TIFFANY ANN (PT, DPT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANN
Last Name:SCHOONOVER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 COUNTRY CLUB PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6043
Mailing Address - Country:US
Mailing Address - Phone:541-683-5139
Mailing Address - Fax:
Practice Address - Street 1:560 COUNTRY CLUB PKWY STE B
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6043
Practice Address - Country:US
Practice Address - Phone:541-683-5139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-13
Last Update Date:2018-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR62726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist