Provider Demographics
NPI:1821242934
Name:SWANBY, SUNNEE GLANCEY (LMP)
Entity Type:Individual
Prefix:MS
First Name:SUNNEE
Middle Name:GLANCEY
Last Name:SWANBY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5402 COOLIDGE CT
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-8483
Mailing Address - Country:US
Mailing Address - Phone:509-947-2312
Mailing Address - Fax:509-371-9999
Practice Address - Street 1:227 SYMONS ST STE A
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-3423
Practice Address - Country:US
Practice Address - Phone:509-947-2312
Practice Address - Fax:509-371-9999
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60025064225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA60025064OtherMASSAGE THERAPIST