Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | MD00024401 | WA |
Y | 207R00000X | Internist | MD00024401 | WA |
Y | 111NI0900X | Internist | MD00024401 | WA |
NPI | 1003917600 |
---|---|
Provider Name | Dr. J David Swift |
First Address | Bremerton, WA 98310 |
Second Address | Bremerton, WA 98310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 09/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012423 | L & I (01) | WA |
1029750 | (05) | WA |
A15051 | (02) | |
SW0033 | REGENCE (01) | WA |