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NPI Code Detail

MEDICARE: SHAUNA B RAFFETY SCHATZ LCSW

MEDICARE: SHAUNA B RAFFETY SCHATZ LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker19956CA
21041C0700XClinical Social WorkerL7072OR
3101YM0800XMental Health CounselorLCSW 25619CA

General Provider Information

NPI Number : 1508982729
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAUNA B RAFFETY SCHATZ LCSW
Provider Business Mailing Address
First Line : 1110 SE ALDER ST STE 301
Second Line :
City : PORTLAND
State : OR
Zip : 97214-2400
Country : US
Telephone Number : 805-316-4333
Fax Number :
Provider Business Practice Location Address
First Line : 1110 SE ALDER ST STE 301
Second Line :
City : PORTLAND
State : OR
Zip : 97214-2400
Country : US
Telephone Number : 805-316-4333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 09/04/2024

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