MEDICARE: SELECT FAMILY CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1184269839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT FAMILY CLINIC LLC

Provider Business Mailing Address
First Line	:	PO BOX 7023
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-0700
Country	:	US
Telephone Number	:	253-470-8078
Fax Number	:	253-248-0139

Provider Business Practice Location Address
First Line	:	28002 STATE ROUTE 410 E STE 5
Second Line	:
City	:	BUCKLEY
State	:	WA
Zip	:	98321-7516
Country	:	US
Telephone Number	:	253-470-8078
Fax Number	:	253-248-0139

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	MAUA W SWAI
Credential	:	ARNP, FNP-C, PMHNP
Telephone Number	:	253-470-8078

Provider Enumeration Date	:	11/16/2019
Last Update Date	:	03/10/2026

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Directions to “SELECT FAMILY CLINIC LLC ” Practice Location

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