Provider Demographics
NPI:1124214143
Name:SWINGLE, WENDY
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:SWINGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 NE MULTNOMAH ST STE 1400
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2598
Mailing Address - Country:US
Mailing Address - Phone:503-488-8326
Mailing Address - Fax:
Practice Address - Street 1:825 NE MULTNOMAH ST STE 1400
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2598
Practice Address - Country:US
Practice Address - Phone:503-488-8326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health