Provider Demographics
NPI:1417090085
Name:LINDA D SWARTZ MD INC
Entity Type:Organization
Organization Name:LINDA D SWARTZ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:SWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-697-4557
Mailing Address - Street 1:20730 BOND RD NE SUITE #201
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-9000
Mailing Address - Country:US
Mailing Address - Phone:360-697-4557
Mailing Address - Fax:360-697-4007
Practice Address - Street 1:20730 BOND RD NE STE 201
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-9000
Practice Address - Country:US
Practice Address - Phone:360-697-4557
Practice Address - Fax:360-697-4007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0027418174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1057736Medicaid
WAG8859605Medicare ID - Type UnspecifiedMEDICARE CLINIC NUMBER
WAE53844Medicare UPIN