Healthcare Provider Details

I. General information

NPI: 1679865067
Provider Name (Legal Business Name): LAURA C. SWANSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 7TH AVE
SEATTLE WA
98104-1132
US

IV. Provider business mailing address

PO BOX 5127
EVERETT WA
98206-5127
US

V. Phone/Fax

Practice location:
  • Phone: 206-860-2326
  • Fax: 206-860-2219
Mailing address:
  • Phone: 206-860-5414
  • Fax: 206-720-8462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD60568793
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: