Provider Demographics
NPI:1003205436
Name:SWEARINGEN, AMANDA L (PT, DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:SWEARINGEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:L
Other - Last Name:LAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:BALANCED PHYSICAL THERAPY
Mailing Address - Street 2:900 NE 139TH ST STE 102
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685
Mailing Address - Country:US
Mailing Address - Phone:360-575-3611
Mailing Address - Fax:360-573-3880
Practice Address - Street 1:BALANCED PHYSICAL THERAPY
Practice Address - Street 2:900 NE 139TH ST STE 102
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685
Practice Address - Country:US
Practice Address - Phone:360-575-3611
Practice Address - Fax:360-573-3880
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61154609225100000X
OR60884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2178778Medicaid