| Thunderegg Counseling Llc | |
|
1916 Sw Madison St Portland OR 97205-1718 | |
| (502) 420-7494 | |
| Not Available |
| Full Name | Thunderegg Counseling Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1916 Sw Madison St, Portland, Oregon |
| Authorized Official Name and Position | Alexander Macleod (ORGANIZER/OWNER/OPERATOR/COUNSELOR) |
| Authorized Official Contact | 5034207494 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thunderegg Counseling Llc Po Box 14484 Portland OR 97293-0484 Ph: () - | Thunderegg Counseling Llc 1916 Sw Madison St Portland OR 97205-1718 Ph: (502) 420-7494 |
| NPI Number | 1508587825 |
|---|---|
| Provider Enumeration Date | 09/06/2022 |
| Last Update Date | 09/20/2022 |
| Certification Date | 09/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508587825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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