Provider Demographics
NPI:1497126445
Name:SWANSON, DEBRA (ND)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:SWANSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:SWANSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:PO BOX 3302
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-4429
Mailing Address - Country:US
Mailing Address - Phone:360-531-7704
Mailing Address - Fax:360-531-6112
Practice Address - Street 1:329 W RAILROAD AVE STE 204
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-3572
Practice Address - Country:US
Practice Address - Phone:360-531-7704
Practice Address - Fax:360-531-6112
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-16
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60605912175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath