Healthcare Provider Details

I. General information

NPI: 1871807081
Provider Name (Legal Business Name): TANIA LOUISE SWISHER BS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7250 VALLEY WOOD PL NE
BREMERTON WA
98311-8205
US

IV. Provider business mailing address

7250 VALLEY WOOD PL NE
BREMERTON WA
98311-8205
US

V. Phone/Fax

Practice location:
  • Phone: 248-660-5505
  • Fax:
Mailing address:
  • Phone: 248-660-5505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberLL 60169852
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: