Provider Demographics
NPI:1407041940
Name:SWANSON, SARA E (MA)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:E
Last Name:SWANSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:SWANSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:PO BOX 681
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-0681
Mailing Address - Country:US
Mailing Address - Phone:360-214-1216
Mailing Address - Fax:
Practice Address - Street 1:1011 27TH ST
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2708
Practice Address - Country:US
Practice Address - Phone:360-214-1216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health