Provider Demographics
NPI:1578825683
Name:SWANSON, SYLVIA S (ARNP-CNM)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:S
Last Name:SWANSON
Suffix:
Gender:F
Credentials:ARNP-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 LENTZ RD
Mailing Address - Street 2:
Mailing Address - City:WINLOCK
Mailing Address - State:WA
Mailing Address - Zip Code:98596-9705
Mailing Address - Country:US
Mailing Address - Phone:360-880-4413
Mailing Address - Fax:360-785-4413
Practice Address - Street 1:521 ADAMS ST
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:WA
Practice Address - Zip Code:98356-9323
Practice Address - Country:US
Practice Address - Phone:360-496-5112
Practice Address - Fax:360-496-3508
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60287997367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife