Provider Demographics
NPI:1922429786
Name:SWARTZ, GRACE (LMP)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:SWARTZ
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 1:2727 E 53RD AVE
Mailing Address - Street 2:APART A305
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7976
Mailing Address - Country:US
Mailing Address - Phone:509-881-9011
Mailing Address - Fax:
Practice Address - Street 1:2727 E 53RD AVE
Practice Address - Street 2:APART A305
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-7976
Practice Address - Country:US
Practice Address - Phone:509-881-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-21
Last Update Date:2013-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60423874225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist