Provider Demographics
NPI:1740492693
Name:SWENDSEN CHIROPRACTIC CLINIC, P.S.
Entity type:Organization
Organization Name:SWENDSEN CHIROPRACTIC CLINIC, P.S.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:L
Authorized Official - Last Name:SWENDSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-845-2013
Mailing Address - Street 1:1011 E MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372
Mailing Address - Country:US
Mailing Address - Phone:253-845-2013
Mailing Address - Fax:
Practice Address - Street 1:1011 E MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372
Practice Address - Country:US
Practice Address - Phone:253-845-2013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty