Healthcare Provider Details

I. General information

NPI: 1700334117
Provider Name (Legal Business Name): ARLENE SCHWENKE BS, QMHSUDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ARLENE DUNN BSQSUDT

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

686 NW 9TH ST.
ONTARIO OR
97914
US

IV. Provider business mailing address

702 SUNSET DRIVE LIFEWAYS RECOVERY CENTER
ONTARIO OR
97914
US

V. Phone/Fax

Practice location:
  • Phone: 541-889-2490
  • Fax: 541-889-5102
Mailing address:
  • Phone: 541-889-2490
  • Fax: 541-889-9167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberBB207270J
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: