Healthcare Provider Details

I. General information

NPI: 1982251195
Provider Name (Legal Business Name): JOSEF SWETZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 D ST SW
TUMWATER WA
98501-4064
US

IV. Provider business mailing address

128 D ST SW
TUMWATER WA
98501-4064
US

V. Phone/Fax

Practice location:
  • Phone: 360-570-9580
  • Fax: 360-570-9583
Mailing address:
  • Phone: 360-570-9580
  • Fax: 360-570-9583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60990926
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: