Provider Demographics
NPI:1750179172
Name:SCHMIDT, TYLER (RN)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7815 N HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-3116
Mailing Address - Country:US
Mailing Address - Phone:509-991-7250
Mailing Address - Fax:
Practice Address - Street 1:7815 N HUDSON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-3116
Practice Address - Country:US
Practice Address - Phone:509-991-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-26
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61302240163WG0000X
OR202213493RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163W00000XNursing Service ProvidersRegistered Nurse