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General NPI Number Information
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NPI Number | 1629138631
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Entity Type | Organization
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Legal Business Name | VIRGINIA E SWANSON MD PLLC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 17791 FJORD DR NE SUITE 110
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City | POULSBO
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State | WA
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Zip | 98370-8481
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Country | US
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Telephone | 360-626-9034
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Fax | 360-626-9046
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Provider Business Mailing Address
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Address Line | 17791 FJORD DR NE SUITE 110
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City | POULSBO
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State | WA
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Zip | 98370-8481
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Country | US
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Telephone | 360-626-9034
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Fax | 360-626-9046
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Authorized Official
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Title or Position | OWNER
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Name | MRS. VIRGINIA E SWANSON
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Credential | MD
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Telephone | 360-626-9034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD00040778
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License Number State | WA
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