Individual
JERRY LEE LESTER SWINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC-R
Contact information
Practice address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(971) 242-8544
Mailing address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(971) 242-8544
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-24-4005
OR
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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