MEDICARE: DR. MARLIN D SCHULTZ D.MIN.

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	106H00000X	Marriage & Family Therapist	TO118	OR

General Provider Information

NPI Number	:	1174613558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARLIN D SCHULTZ D.MIN.

Provider Business Mailing Address
First Line	:	4669 E AMAZON DR
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97405-4655
Country	:	US
Telephone Number	:	541-485-6952
Fax Number	:

Provider Business Practice Location Address
First Line	:	1627 OAK ST
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-4022
Country	:	US
Telephone Number	:	541-343-9190
Fax Number	:	541-343-3975

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	07/08/2007

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