Provider Demographics
NPI:1265667315
Name:SWINNERTON, GERALD ARTHUR (MSW )
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:ARTHUR
Last Name:SWINNERTON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9160
Mailing Address - Country:US
Mailing Address - Phone:509-627-1007
Mailing Address - Fax:509-627-1007
Practice Address - Street 1:1045 JADWIN AVE
Practice Address - Street 2:STE C
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3405
Practice Address - Country:US
Practice Address - Phone:509-627-1007
Practice Address - Fax:509-627-1007
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist