| Black Swan Healing Llc | |
|
5441 S Macadam Ave Ste N Portland OR 97239-6106 | |
| (971) 268-7462 | |
| (971) 202-9584 |
| Full Name | Black Swan Healing Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5441 S Macadam Ave Ste N, Portland, Oregon |
| Authorized Official Name and Position | Nicholas A Mcgee (COUNSELOR/OWNER) |
| Authorized Official Contact | 3603932125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Swan Healing Llc 5441 S Macadam Ave Ste N Portland OR 97239-6106 Ph: (360) 393-2125 | Black Swan Healing Llc 5441 S Macadam Ave Ste N Portland OR 97239-6106 Ph: (971) 268-7462 |
| NPI Number | 1023849882 |
|---|---|
| Provider Enumeration Date | 08/12/2024 |
| Last Update Date | 02/03/2025 |
| Certification Date | 01/28/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023849882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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