Provider Demographics
NPI:1861436412
Name:SCHUETTE, TIMOTHY DANIEL (ATC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:DANIEL
Last Name:SCHUETTE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3239 SW 179TH TER
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-3965
Mailing Address - Country:US
Mailing Address - Phone:971-246-1228
Mailing Address - Fax:
Practice Address - Street 1:18550 SW KINNAMAN RD
Practice Address - Street 2:ALOHA HIGH SCHOOL
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-2465
Practice Address - Country:US
Practice Address - Phone:503-259-4864
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAT-AT-9270342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer