Provider Demographics
NPI:1326365941
Name:SWARTLING, JEFFERY EMIL (LMP)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:EMIL
Last Name:SWARTLING
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 CLEVELAND AVE SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4001
Mailing Address - Country:US
Mailing Address - Phone:360-754-8418
Mailing Address - Fax:360-754-0060
Practice Address - Street 1:121 CLEVELAND AVE SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-4001
Practice Address - Country:US
Practice Address - Phone:360-754-8418
Practice Address - Fax:360-754-0060
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00019161174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist