MEDICARE: MS. KARISSA LYNN SCHWARTZ MA, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	15006	OR

General Provider Information

NPI Number	:	1023507795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KARISSA LYNN SCHWARTZ MA, CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 6722
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97228-6722
Country	:	US
Telephone Number	:	971-244-3757
Fax Number	:

Provider Business Practice Location Address
First Line	:	PROVIDENCE PORTLAND MEDICAL CENTER
Second Line	:	4805 NE GLISAN ST
City	:	PORTLAND
State	:	OR
Zip	:	97213
Country	:	US
Telephone Number	:	503-215-1111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2018
Last Update Date	:	05/08/2018

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Directions to “ MS. KARISSA LYNN SCHWARTZ MA, CCC-SLP” Practice Location

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