Provider Demographics
NPI:1003917600
Name:SWIFT, J DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:DAVID
Last Name:SWIFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2601 CHERRY AVENUE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310
Mailing Address - Country:US
Mailing Address - Phone:360-479-4580
Mailing Address - Fax:360-479-0424
Practice Address - Street 1:2601 CHERRY AVENUE
Practice Address - Street 2:SUITE 302
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310
Practice Address - Country:US
Practice Address - Phone:360-479-4580
Practice Address - Fax:360-479-0424
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00024401207QA0505X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1029750Medicaid
WA0012423OtherL & I
WASW0033OtherREGENCE
WA0012423OtherL & I
WASW0033OtherREGENCE