Provider Demographics
NPI:1366842007
Name:SWAFFORD, KRISTEN (PHD, RN, CNS)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:SWAFFORD
Suffix:
Gender:F
Credentials:PHD, RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23375 NE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GASTON
Mailing Address - State:OR
Mailing Address - Zip Code:97119-8402
Mailing Address - Country:US
Mailing Address - Phone:503-841-8174
Mailing Address - Fax:
Practice Address - Street 1:23375 NE RIDGE RD
Practice Address - Street 2:
Practice Address - City:GASTON
Practice Address - State:OR
Practice Address - Zip Code:97119-8402
Practice Address - Country:US
Practice Address - Phone:503-841-8174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200241377RN163W00000X
OR200670004CNS163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163W00000XNursing Service ProvidersRegistered Nurse