Provider Demographics
NPI:1790848018
Name:SWENSON, JOHN PALMER (BPHARM, MS, FASHP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PALMER
Last Name:SWENSON
Suffix:
Gender:M
Credentials:BPHARM, MS, FASHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 RIVIERA DR
Mailing Address - Street 2:PO BOX 1507
Mailing Address - City:CHELAN
Mailing Address - State:WA
Mailing Address - Zip Code:98816-9552
Mailing Address - Country:US
Mailing Address - Phone:509-682-0510
Mailing Address - Fax:
Practice Address - Street 1:1201 S MILLER ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3201
Practice Address - Country:US
Practice Address - Phone:509-662-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00009095183500000X
CA25921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist