Provider Demographics
NPI:1477543395
Name:SWANLUND, JENNIFER K (DPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:K
Last Name:SWANLUND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10315 NE TANASBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7836
Mailing Address - Country:US
Mailing Address - Phone:503-495-8505
Mailing Address - Fax:
Practice Address - Street 1:10315 NE TANASBOURNE DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7836
Practice Address - Country:US
Practice Address - Phone:503-495-8505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4495225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist