Provider Demographics
NPI:1093880973
Name:SWANSON, PATRICIA SUSAN (MA, LMFT, LMHC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUSAN
Last Name:SWANSON
Suffix:
Gender:F
Credentials:MA, LMFT, LMHC
Other - Prefix:
Other - First Name:PATTY
Other - Middle Name:
Other - Last Name:SWANSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMFT, LMHC
Mailing Address - Street 1:6108 COMMUNITY PL SW
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2447
Mailing Address - Country:US
Mailing Address - Phone:253-582-1502
Mailing Address - Fax:253-584-0436
Practice Address - Street 1:6108 COMMUNITY PL SW
Practice Address - Street 2:SUITE 3
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2447
Practice Address - Country:US
Practice Address - Phone:253-582-1502
Practice Address - Fax:253-584-0436
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005073101YM0800X
WALF00001206106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist