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General NPI Number Information
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NPI Number | 1134554504
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Entity Type | Individual
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Provider Name | MICHAEL SWENSON OTR/L
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Gender | Male
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 791 SE FIDALGO AVE STE 101
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City | OAK HARBOR
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State | WA
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Zip | 98277-5505
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Country | US
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Telephone | 360-678-4068
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Fax | 360-678-4087
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Provider Business Mailing Address
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Address Line | 1940 BEACHWOOD DR
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City | FREELAND
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State | WA
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Zip | 98249-9537
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 00004448
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License Number State | WA
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