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General NPI Number Information
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NPI Number | 1447924899
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Entity Type | Individual
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Provider Name | ANDREW SCHWAGER
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Gender | Male
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Dates
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Enumeration Date | 08/08/2021
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 5623 SE LEXINGTON ST
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City | PORTLAND
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State | OR
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Zip | 97206-9025
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Country | US
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Telephone | 607-227-8119
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Fax |
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Provider Business Mailing Address
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Address Line | 117 PINE TREE RD
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City | ITHACA
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State | NY
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Zip | 14850-6331
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Country | US
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Telephone | 607-227-8119
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L16471
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License Number State | OR
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