Provider Demographics
NPI:1851782247
Name:SWAN, SVETLANA (ARNP)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:SWAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 960
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98337-0212
Mailing Address - Country:US
Mailing Address - Phone:360-377-3776
Mailing Address - Fax:
Practice Address - Street 1:19917 7TH AVE NE
Practice Address - Street 2:SUITE 205
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6555
Practice Address - Country:US
Practice Address - Phone:360-779-1963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60485701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily