Provider Demographics
NPI:1417209172
Name:SWANSON, MICHELLE MEICHIH (MSTCM LAC MS PHD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MEICHIH
Last Name:SWANSON
Suffix:
Gender:F
Credentials:MSTCM LAC MS PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E MAIN AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3661
Mailing Address - Country:US
Mailing Address - Phone:408-782-8500
Mailing Address - Fax:408-782-5199
Practice Address - Street 1:50 E MAIN AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3661
Practice Address - Country:US
Practice Address - Phone:408-782-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14998171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist