Healthcare Provider Details

I. General information

NPI: 1922071927
Provider Name (Legal Business Name): STEPHEN JOSEPH SCHUETZ PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 06/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 NW 27TH ST
CORVALLIS OR
97330-5223
US

IV. Provider business mailing address

1800 NW GARFIELD AVE
CORVALLIS OR
97330-2536
US

V. Phone/Fax

Practice location:
  • Phone: 541-753-6833
  • Fax:
Mailing address:
  • Phone: 541-753-6833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number590
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: