Provider Demographics
NPI:1700334117
Name:SCHWENKE, ARLENE (BS, QMHSUDT)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:SCHWENKE
Suffix:
Gender:F
Credentials:BS, QMHSUDT
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSQSUDT
Mailing Address - Street 1:702 SUNSET DRIVE
Mailing Address - Street 2:LIFEWAYS RECOVERY CENTER
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914
Mailing Address - Country:US
Mailing Address - Phone:541-889-2490
Mailing Address - Fax:541-889-9167
Practice Address - Street 1:686 NW 9TH ST.
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914
Practice Address - Country:US
Practice Address - Phone:541-889-2490
Practice Address - Fax:541-889-5102
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDBB207270J1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool