Individual
MR. RONALD MARTIN SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
3550 N. INTERSTATE AVENUE, PORTLAND, OR 97227-1043
(503) 285-9321
(503) 249-5508
Mailing address
3550 N INTERSTATE AVE, KAISER PERMANENTE INTERSTATE MEDICAL OFFICE E, PORTLAND, OR 97227-1043
(503) 249-5275
(503) 249-5508
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OR CO947
OR
101YM0800X
Mental Health Counselor
WA LH00004068
WA
Other
Enumeration date
08/30/2006
Last updated
10/27/2007
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