Provider Demographics
NPI:1619062890
Name:SWARTZ, ANITA LOUISE (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:LOUISE
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51967 HWY 203
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:OR
Mailing Address - Zip Code:97883
Mailing Address - Country:US
Mailing Address - Phone:541-853-2330
Mailing Address - Fax:
Practice Address - Street 1:3990 MIDWAY DRIVE
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814
Practice Address - Country:US
Practice Address - Phone:541-523-2983
Practice Address - Fax:541-523-5300
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10426235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR297183Medicaid