MEDICARE: MEGAN SWARTZ ATC/L

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	2255A2300X	Athletic Trainer	A1 60502375	WA

General Provider Information

NPI Number	:	1396121943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN SWARTZ ATC/L

Provider Business Mailing Address
First Line	:	1122 228TH AVE SE
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98075-9509
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 228TH AVE SE
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98075-9509
Country	:	US
Telephone Number	:	425-837-7896
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2015
Last Update Date	:	08/05/2015

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