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Individual

ELIZABETH VIRGINIA SWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRM

Contact information

Practice address
1 SERENITY LN, COBURG, OR 97408-9350
(541) 687-1110
Mailing address
1 SERENITY LN, COBURG, OR 97408-9350
(541) 687-1110

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OR
175T00000X
Peer Specialist
24-CRM-3618
OR

Other

Enumeration date
01/13/2025
Last updated
02/12/2026
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