Provider Demographics
NPI:1205981107
Name:SWARTSEL, ANDREW C (PA-C)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:C
Last Name:SWARTSEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:C
Other - Last Name:SWARTSEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1092
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:WA
Mailing Address - Zip Code:98812-1092
Mailing Address - Country:US
Mailing Address - Phone:509-689-6666
Mailing Address - Fax:509-689-2330
Practice Address - Street 1:529 JASMINE ST
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841
Practice Address - Country:US
Practice Address - Phone:509-826-1600
Practice Address - Fax:509-826-3633
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00096318163W00000X
WAPA10003662363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No163W00000XNursing Service ProvidersRegistered Nurse
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7676SWOtherASURIS
WA0198873OtherL AND I
WA8906544OtherCRIME VICTIMS
WA8350068Medicaid
WA8350068Medicaid
WAMS0319334OtherDEA
WA8350068Medicaid