Provider Demographics
NPI:1437416377
Name:SWIFT, LEAH BAHN (DO)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:BAHN
Last Name:SWIFT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2847
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-2847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:531 N HIGHWAY 101 STE A
Practice Address - Street 2:
Practice Address - City:DEPOE BAY
Practice Address - State:OR
Practice Address - Zip Code:97341-9572
Practice Address - Country:US
Practice Address - Phone:541-765-3265
Practice Address - Fax:541-765-3260
Is Sole Proprietor?:No
Enumeration Date:2012-04-17
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-01414208000000X
ORDO204314208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1437416377Medicaid
NC1550817OtherWELLPATH
NC1437416377OtherHEALTHSMART
NC1437416377OtherHUMANA
NC296288OtherMEDCOST
NC5383832OtherAETNA
NC19DTROtherBCBS OF NC
NC5591611OtherUNITED HEALTHCARE
NCFH1101855OtherFIRST CAROLINA CARE
NC1437416377OtherHEALTHNET FEDERAL SERVICES
NC4571410OtherCOVENTRY NATIONAL- COVENTRY PPO
NC13436877OtherPHCS/MULTIPLAN
NC1437416377OtherDOCTORS DIRECT
NC1550817OtherCOVENTRY OF THE CAROLINAS
NC5682542OtherCIGNA/GREATWEST