Provider Demographics
NPI:1437515244
Name:SWAN, PATRICIA J (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:SWAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2660 NE HIGHWAY 20 STE 610
Mailing Address - Street 2:BOX 217
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6403
Mailing Address - Country:US
Mailing Address - Phone:541-617-8989
Mailing Address - Fax:541-318-1709
Practice Address - Street 1:22022 NELSON RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-9790
Practice Address - Country:US
Practice Address - Phone:541-617-8989
Practice Address - Fax:541-318-1709
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1814101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health