MEDICARE: DR. JAMES D. SWENSON M.D.

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	207X00000X	Orthopaedic Surgery Physician	MD00031103	WA

General Provider Information

NPI Number	:	1417994278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES D. SWENSON M.D.

Provider Business Mailing Address
First Line	:	805 MADISON ST
Second Line	:	SUITE 901
City	:	SEATTLE
State	:	WA
Zip	:	98104-1172
Country	:	US
Telephone Number	:	206-264-8100
Fax Number	:	206-264-8689

Provider Business Practice Location Address
First Line	:	14841 179TH AVE SE
Second Line	:	SUITE 330
City	:	MONROE
State	:	WA
Zip	:	98272-1161
Country	:	US
Telephone Number	:	360-794-3300
Fax Number	:	360-794-6610

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	07/19/2012

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