Provider Demographics
NPI:1063612893
Name:SCHIESTL, KATHLEEN HAHN (PT)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:HAHN
Last Name:SCHIESTL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 NE HALSEY ST STE 340
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-1568
Mailing Address - Country:US
Mailing Address - Phone:503-288-4643
Mailing Address - Fax:503-208-7016
Practice Address - Street 1:4224 NE HALSEY ST STE 340
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1568
Practice Address - Country:US
Practice Address - Phone:503-288-4643
Practice Address - Fax:503-208-7016
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5335225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR138761Medicare PIN
OR138337Medicare PIN