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General NPI Number Information
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NPI Number | 1902298623
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Entity Type | Individual
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Provider Name | STEVEN SWANSON
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Gender | Male
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 702 S HILL PARK DR STE 101
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City | PUYALLUP
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State | WA
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Zip | 98373-1426
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Country | US
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Telephone | 253-604-4953
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Fax | 253-604-4956
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Provider Business Mailing Address
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Address Line | 5006 CENTER ST STE N
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City | TACOMA
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State | WA
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Zip | 98409-2314
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Country | US
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Telephone | 253-476-0449
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Fax | 253-476-0286
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT60529872
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License Number State | WA
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