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1114768348
JERRY LEE LESTER SWINGER
PORTLAND, OR
NPI
1114768348
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-24-4005)
Enumeration Date
2024-06-03
Last Update Date
2024-06-03
Business Address
JERRY LEE LESTER SWINGER CADC-R
211 NE 18TH AVE
PORTLAND, OR 97232-2822
Phone number: 971-242-8544
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Mailing Address
JERRY LEE LESTER SWINGER CADC-R
211 NE 18TH AVE
PORTLAND, OR 97232-2822
Phone number: 971-242-8544
Copy
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