Healthcare Provider Details

I. General information

NPI: 1104589431
Provider Name (Legal Business Name): TONI NICOLE SCHWEYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 SUPERIOR LN
YAKIMA WA
98902-1623
US

IV. Provider business mailing address

1407 S 36TH AVE
YAKIMA WA
98902-4812
US

V. Phone/Fax

Practice location:
  • Phone: 509-575-4810
  • Fax:
Mailing address:
  • Phone: 509-759-4814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP61374673
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCO61202875
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: