Provider Demographics
NPI:1760259840
Name:SCHWISOW, CARMEN (MSW)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:SCHWISOW
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10202 SE 32ND AVE STE 701
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-3625
Mailing Address - Country:US
Mailing Address - Phone:503-496-3201
Mailing Address - Fax:
Practice Address - Street 1:10202 SE 32ND AVE STE 701
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-3625
Practice Address - Country:US
Practice Address - Phone:503-496-3201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X1041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical