Provider Demographics
NPI:1811513088
Name:SWANSON, CHLOE
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:
Last Name:SWANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2143
Mailing Address - Country:US
Mailing Address - Phone:360-224-5024
Mailing Address - Fax:
Practice Address - Street 1:813 QUEEN ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-2143
Practice Address - Country:US
Practice Address - Phone:360-224-5024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAWDLB65T8G53BOtherDRIVERS LICENSE