Provider Demographics
NPI:1235652512
Name:SWANBERG, ANNA MAE
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:MAE
Last Name:SWANBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ANNA
Other - Middle Name:MAE
Other - Last Name:BULGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1227 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4906
Mailing Address - Country:US
Mailing Address - Phone:360-651-2366
Mailing Address - Fax:
Practice Address - Street 1:1227 2ND ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270
Practice Address - Country:US
Practice Address - Phone:360-651-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)