Provider Demographics
NPI:1164480448
Name:SWINGEN, LAURA A (DC, DACNB)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:A
Last Name:SWINGEN
Suffix:
Gender:F
Credentials:DC, DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11507 SW SHILO LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5923
Mailing Address - Country:US
Mailing Address - Phone:503-643-2225
Mailing Address - Fax:503-520-0514
Practice Address - Street 1:11507 SW SHILO LN
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225
Practice Address - Country:US
Practice Address - Phone:503-643-2225
Practice Address - Fax:503-520-0514
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-2662111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111N00000XChiropractic ProvidersChiropractor