Provider Demographics
NPI:1801644091
Name:MCEACHRAN, MINDY (MFTA)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:MCEACHRAN
Suffix:
Gender:F
Credentials:MFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7522 SW ASHFORD ST
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7143
Mailing Address - Country:US
Mailing Address - Phone:720-234-8505
Mailing Address - Fax:
Practice Address - Street 1:4537 SW 96TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3329
Practice Address - Country:US
Practice Address - Phone:503-376-9520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-11
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist