Provider Demographics
NPI:1760611461
Name:SCHNEIDER, DAWN L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:L
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 SE HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-3538
Mailing Address - Country:US
Mailing Address - Phone:503-522-1439
Mailing Address - Fax:503-327-8005
Practice Address - Street 1:346 SE 44TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1007
Practice Address - Country:US
Practice Address - Phone:503-522-1439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL14331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical