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General NPI Number Information
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NPI Number | 1154766293
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Entity Type | Individual
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Provider Name | KARLY DAWN SWANSON LMP
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Gender | Female
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Dates
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Enumeration Date | 05/02/2013
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 505 HWY 2 STE. 100
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City | LEAVENWORTH
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State | WA
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Zip | 98826
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Country | US
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Telephone | 509-548-8081
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 2114
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City | LEAVENWORTH
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State | WA
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Zip | 98826
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Country | US
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Telephone | 425-381-6695
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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 | MA60332652
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License Number State | WA
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