Melanie Swallow, | |
1945 Ne 205th Ave, Fairview, OR 97024-9622 | |
(541) 858-8170 | |
(541) 858-8167 |
Full Name | Melanie Swallow |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 1945 Ne 205th Ave, Fairview, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265717292 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | L6502 (* (Not Available)) | Primary |
Entity Name | Tiffany Kettermann, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003461740 PECOS PAC ID: 0941685184 Enrollment ID: O20220923001810 |
Mailing Address | Practice Location Address |
---|---|
Melanie Swallow, 3587 Heathrow Way, Medford, OR 97504-4004 Ph: (541) 858-8170 | Melanie Swallow, 1945 Ne 205th Ave, Fairview, OR 97024-9622 Ph: (541) 858-8170 |
Dr. Naomi Ann Mandsager, LPC, PH. D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1450 Ne Village St, Fairview, OR 97024 Phone: 503-492-4492 | |
Lisa Cordero, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1945 Ne 205th Ave, Fairview, OR 97024 Phone: 503-661-8050 Fax: 503-492-4651 | |
Lara Loughlin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1945 Ne 205th Ave, Fairview, OR 97024 Phone: 541-858-8170 Fax: 541-858-8167 | |
Denise Maddock, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1945 Ne 205th Ave, Fairview, OR 97024 Phone: 503-661-8050 Fax: 503-492-4651 | |
Sarah Bourgeois, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1945 Ne 205th Ave, Fairview, OR 97024 Phone: 503-661-8050 Fax: 503-492-4651 | |
Ms. Tammy Marie Lundbom, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2714 Ne 205th Ave Apt 228, Fairview, OR 97024 Phone: 503-914-9768 | |
Clinton Stiffler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1945 Ne 205th Ave, Fairview, OR 97024 Phone: 503-661-8050 Fax: 503-492-4651 |