Healthcare Provider Details

I. General information

NPI: 1588949366
Provider Name (Legal Business Name): JASON RAYMOND SWIFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2011
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1477 N 2000 W
CLINTON UT
84015-8638
US

IV. Provider business mailing address

1477 N 2000 W
CLINTON UT
84015-8638
US

V. Phone/Fax

Practice location:
  • Phone: 801-773-4840
  • Fax: 801-525-3159
Mailing address:
  • Phone: 801-773-4840
  • Fax: 801-525-3159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: