Provider Demographics
NPI:1669581542
Name:SCHWEIGHARDT, SUSAN KRETZMANN (PT)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:KRETZMANN
Last Name:SCHWEIGHARDT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:KRETZMANN
Other - Last Name:BAMBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3364 HILLSIDE CT
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OR
Mailing Address - Zip Code:97032-9632
Mailing Address - Country:US
Mailing Address - Phone:503-701-4622
Mailing Address - Fax:
Practice Address - Street 1:3364 HILLSIDE CT
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OR
Practice Address - Zip Code:97032-9632
Practice Address - Country:US
Practice Address - Phone:503-701-4622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3905225100000X, 225100000X
WA8064208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR139607Medicare PIN