Healthcare Provider Details

I. General information

NPI: 1346346566
Provider Name (Legal Business Name): HOLLY SUZANNE SCHAFFER M.A. LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 SW HAMPTON ST STE 125
TIGARD OR
97223-8361
US

IV. Provider business mailing address

7000 SW HAMPTON ST STE 125
TIGARD OR
97223-8361
US

V. Phone/Fax

Practice location:
  • Phone: 503-550-5089
  • Fax: 202-908-5389
Mailing address:
  • Phone: 503-550-5089
  • Fax: 202-908-5389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC21022
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: