Healthcare Provider Details

I. General information

NPI: 1841126331
Provider Name (Legal Business Name): ALEXANDRA ELIZABETH SCHUCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 WESTGATE
PENDLETON OR
97801-9613
US

IV. Provider business mailing address

1437 SW 37TH ST UNIT 26
PENDLETON OR
97801-3665
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-1126
  • Fax:
Mailing address:
  • Phone: 541-969-6107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: