Healthcare Provider Details

I. General information

NPI: 1861009896
Provider Name (Legal Business Name): SWENSON PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 PACIFIC AVE STE 400
TACOMA WA
98402-4381
US

IV. Provider business mailing address

1201 PACIFIC AVE STE 400
TACOMA WA
98402-4381
US

V. Phone/Fax

Practice location:
  • Phone: 253-300-8453
  • Fax: 253-559-6188
Mailing address:
  • Phone: 253-300-8453
  • Fax: 253-559-6188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DARREN SWENSON
Title or Position: CEO
Credential: MD
Phone: 253-300-8453