Organization
THUNDEREGG COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER MACLEOD CRC, NCC (ORGANIZER/OWNER/OPERATOR/COUNSELOR)
(503) 420-7494
Entity
Organization
Contact information
Practice address
1916 SW MADISON ST, PORTLAND, OR 97205-1718
(502) 420-7494
Mailing address
PO BOX 14484, PORTLAND, OR 97293-0484
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/06/2022
Last updated
09/20/2022
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