Healthcare Provider Details

I. General information

NPI: 1942274170
Provider Name (Legal Business Name): DARREN R SWENSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 PACIFIC AVE STE 600
TACOMA WA
98402-4384
US

IV. Provider business mailing address

1201 PACIFIC AVE STE 600
TACOMA WA
98402-4384
US

V. Phone/Fax

Practice location:
  • Phone: 253-203-3131
  • Fax: 253-214-0061
Mailing address:
  • Phone: 253-203-3131
  • Fax: 253-214-0061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number11397
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number11397
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: