Provider Demographics
NPI:1821580754
Name:SWANBERG, AARON ARTHUR
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:ARTHUR
Last Name:SWANBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23019 29TH AVE W
Mailing Address - Street 2:
Mailing Address - City:BRIER
Mailing Address - State:WA
Mailing Address - Zip Code:98036-8313
Mailing Address - Country:US
Mailing Address - Phone:425-954-9945
Mailing Address - Fax:
Practice Address - Street 1:4746 11TH AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4660
Practice Address - Country:US
Practice Address - Phone:206-535-8876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty