Provider Demographics
NPI:1851519102
Name:SCHUETZ, DEIDRE MARIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:DEIDRE
Middle Name:MARIE
Last Name:SCHUETZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 NW GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-2536
Mailing Address - Country:US
Mailing Address - Phone:503-730-4452
Mailing Address - Fax:
Practice Address - Street 1:4512 SE WOODSTOCK BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-6274
Practice Address - Country:US
Practice Address - Phone:503-777-2776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12360174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist