Healthcare Provider Details

I. General information

NPI: 1245473933
Provider Name (Legal Business Name): EMMA LAYTON SWINGLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2009
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7210 ROOSEVELT WAY NE
SEATTLE WA
98115-5600
US

IV. Provider business mailing address

PO BOX 25608
SALT LAKE CITY UT
84125-0608
US

V. Phone/Fax

Practice location:
  • Phone: 206-320-3400
  • Fax: 206-320-5773
Mailing address:
  • Phone: 206-320-3400
  • Fax: 206-320-5773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60286661
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number60286661
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: