Healthcare Provider Details

I. General information

NPI: 1023335478
Provider Name (Legal Business Name): JOHN DAVID MCSWIGAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 SW WALNUT ST
HILLSBORO OR
97123-5651
US

IV. Provider business mailing address

971 SW WALNUT ST
HILLSBORO OR
97123-5651
US

V. Phone/Fax

Practice location:
  • Phone: 503-640-5297
  • Fax: 503-640-5780
Mailing address:
  • Phone: 503-640-5297
  • Fax: 503-640-5780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: