Healthcare Provider Details

I. General information

NPI: 1750177978
Provider Name (Legal Business Name): NATHAN SWALLOW DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 SE BISHOP BLVD STE 401
PULLMAN WA
99163-5517
US

IV. Provider business mailing address

840 SE BISHOP BLVD STE 103
PULLMAN WA
99163-5502
US

V. Phone/Fax

Practice location:
  • Phone: 509-336-7720
  • Fax:
Mailing address:
  • Phone: 509-336-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOL61691291
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: