Provider Demographics
NPI:1326226770
Name:SWALBERG, AMBER (LMT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:SWALBERG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 SE 10TH ST
Mailing Address - Street 2:#64
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-6100
Mailing Address - Country:US
Mailing Address - Phone:360-771-7317
Mailing Address - Fax:
Practice Address - Street 1:11301 SE 10TH ST
Practice Address - Street 2:#64
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-6100
Practice Address - Country:US
Practice Address - Phone:360-771-7317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023080225700000X
UT5620978-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist