Healthcare Provider Details

I. General information

NPI: 1649169111
Provider Name (Legal Business Name): MARISSA SWANSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 161ST AVE NE STE 208
REDMOND WA
98052-3858
US

IV. Provider business mailing address

8301 161ST AVE NE STE 208
REDMOND WA
98052-3858
US

V. Phone/Fax

Practice location:
  • Phone: 425-882-4347
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: