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General NPI Number Information
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NPI Number | 1003267295
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Entity Type | Individual
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Provider Name | CATHERINE SWENSON LMT, CMT
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Gender | Female
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 1118 2ND AVE
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City | FAIRBANKS
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State | AK
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Zip | 99701-4228
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Country | US
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Telephone | 907-456-6213
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Fax |
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Provider Business Mailing Address
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Address Line | 3295 TRANQUILITY CT #3
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City | NORTH POLE
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State | AK
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Zip | 99705-6380
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Country | US
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Telephone | 907-687-7609
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 101430
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License Number State | AK
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