Provider Demographics
NPI:1386204311
Name:SWAN, HANNAH JOY
Entity Type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:JOY
Last Name:SWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7550 WILLIS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON
Mailing Address - State:OR
Mailing Address - Zip Code:97496-5555
Mailing Address - Country:US
Mailing Address - Phone:971-240-9598
Mailing Address - Fax:
Practice Address - Street 1:761 SW WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-3413
Practice Address - Country:US
Practice Address - Phone:971-240-9598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
ORDEM-LD-10208835176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula