person
Swan Grace Mandujano, CRM/PSS
Addiction (Substance Use Disorder) Counselor in Portland, Oregon
NPI 1891410866

Swan Grace Mandujano is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). Swan Grace Mandujano practices in Portland, OR and has the professional credentials of CRM/PSS. The NPI Number for Swan Grace Mandujano is 1891410866 and holds a License No. THW000106701 (Oregon).

The current practice location address for Swan Grace Mandujano is 1631 Sw Columbia St, Portland, OR and can be reached out via phone at 503-231-2641 and via fax at 503-231-1654.

Location: 1631 Sw Columbia St, Portland, OR, 97205-1715
person
Provider Profile Details
NPI Number
1891410866
Provider Name
Swan Grace Mandujano
Credential
CRM/PSS
Provider Entity Type
Individual
Gender
Female
Address
1631 Sw Columbia St, Portland, OR, 97205-1715
Phone Number
503-231-2641
Fax Number
503-231-1654
Provider Enumeration Date
10/11/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1631 Sw Columbia St
City
State
Zip
97201-6025
Phone Number
503-231-2641
Fax Number
503-231-1654
person
Provider Business Mailing Address Details
Address
1631 Sw Columbia St
City
State
Zip
97201-6025
Phone Number
503-231-2641
Fax Number
503-231-1654
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
22-CRM-957 (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
THW000106701 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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