Provider Demographics
NPI:1609019249
Name:SWANSON, HEATHER (PHD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:SWANSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11911 NE 1ST ST STE 208
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3056
Mailing Address - Country:US
Mailing Address - Phone:425-351-0392
Mailing Address - Fax:425-620-3725
Practice Address - Street 1:11911 NE 1ST ST STE 208
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005
Practice Address - Country:US
Practice Address - Phone:425-351-0392
Practice Address - Fax:425-620-3725
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist