MEDICARE: LAUREN SWIDERSKI MT-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225A00000X	Music Therapist

General Provider Information

NPI Number	:	1174177075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN SWIDERSKI MT-BC

Provider Business Mailing Address
First Line	:	1420 13TH AVE SE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98501-2542
Country	:	US
Telephone Number	:	206-556-5662
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 S I ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-4212
Country	:	US
Telephone Number	:	206-556-5662
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2019
Last Update Date	:	07/29/2019

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Directions to “ LAUREN SWIDERSKI MT-BC” Practice Location

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