Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | RN338129 | CA |
NPI | 1548336571 |
---|---|
Provider Name | Audrey Swann |
First Address | Seattle, WA 98124-1703 |
Second Address | Bellingham, WA 98226-8037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 12/01/2010 |