Provider Demographics
NPI:1255422762
Name:SCHULTZE, JOAN (DC)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:
Last Name:SCHULTZE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 3RD ST STE A3
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-5052
Mailing Address - Country:US
Mailing Address - Phone:503-636-6186
Mailing Address - Fax:
Practice Address - Street 1:543 3RD ST STE A3
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-5052
Practice Address - Country:US
Practice Address - Phone:503-636-6186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor