Provider Demographics
NPI:1487790796
Name:SCHERMELE, DANIEL WILLIAM CONRAD (BA)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:WILLIAM CONRAD
Last Name:SCHERMELE
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 NE PRESCOTT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-3983
Mailing Address - Country:US
Mailing Address - Phone:406-546-0554
Mailing Address - Fax:
Practice Address - Street 1:4729 SE 75TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-4351
Practice Address - Country:US
Practice Address - Phone:503-788-1680
Practice Address - Fax:503-788-1686
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion