Provider Demographics
NPI:1811766454
Name:SCHOFIELD, ALEXIS JULIANA (MA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:JULIANA
Last Name:SCHOFIELD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2176 SE PALMQUIST RD
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-7943
Mailing Address - Country:US
Mailing Address - Phone:503-956-0310
Mailing Address - Fax:
Practice Address - Street 1:12306 SE MILL PLAIN BLVD STE 250
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6072
Practice Address - Country:US
Practice Address - Phone:360-977-3798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR8708101YM0800X
WAMC61474559101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health