Provider Demographics
NPI:1740696129
Name:SWAN, MELINDA S (QMHP)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:S
Last Name:SWAN
Suffix:
Gender:
Credentials:QMHP
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:S
Other - Last Name:PEERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8459
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97207-8459
Mailing Address - Country:US
Mailing Address - Phone:503-238-0769
Mailing Address - Fax:
Practice Address - Street 1:627 NE EVANS ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-3923
Practice Address - Country:US
Practice Address - Phone:503-434-7526
Practice Address - Fax:503-434-9846
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor