Provider Demographics
NPI:1215006309
Name:SWYERS, TONYA NICOLE (LMP)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:NICOLE
Last Name:SWYERS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4684
Mailing Address - Country:US
Mailing Address - Phone:360-424-2015
Mailing Address - Fax:
Practice Address - Street 1:5301 EVERGREEN WAY
Practice Address - Street 2:STE B
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-3631
Practice Address - Country:US
Practice Address - Phone:425-257-1000
Practice Address - Fax:425-353-6787
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019975225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist