Healthcare Provider Details

I. General information

NPI: 1952246464
Provider Name (Legal Business Name): KAITLYN SCHWENTKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 5TH ST
OREGON CITY OR
97045-2444
US

IV. Provider business mailing address

1010 5TH ST
OREGON CITY OR
97045-2444
US

V. Phone/Fax

Practice location:
  • Phone: 503-954-1890
  • Fax: 971-888-4607
Mailing address:
  • Phone: 503-954-1890
  • Fax: 971-888-4607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: