Healthcare Provider Details

I. General information

NPI: 1487728044
Provider Name (Legal Business Name): KRISTY SWIFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 NW BUCKLIN HILL RD # 101
SILVERDALE WA
98383-8503
US

IV. Provider business mailing address

16870 LARK LN NW
POULSBO WA
98370-8340
US

V. Phone/Fax

Practice location:
  • Phone: 360-692-2301
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberLL00002800
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: