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General NPI Number Information
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NPI Number | 1891098893
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Entity Type | Individual
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Provider Name | AUDREY LIZ SCHWARTZ PHD
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Gender | Female
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 02/08/2018
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Provider Practice Location Address
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Address Line | 1300 NW HARRISON BLVD
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City | CORVALLIS
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State | OR
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Zip | 97330-6277
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Country | US
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Telephone | 541-257-7414
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Fax |
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Provider Business Mailing Address
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Address Line | 2992 NE NEWCASTLE PL
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City | CORVALLIS
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State | OR
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Zip | 97330-4118
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Country | US
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Telephone | 541-910-1361
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2658
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License Number State | OR
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