Active NPI
Michael Dean Swanson, PT
- Physical Therapist
- Spokane, WA
National Provider Identifier
1013099035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00008637
- Practice address
- 785 E Holland Ave
Spokane, WA 99218-1257 - Phone
- (509) 466-6393
- Fax
- (509) 466-5163
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00008637 | WA | Primary |
Addresses
Primary practice location
785 E Holland Ave
Spokane, WA 99218-1257
Mailing address
785 E Holland Ave
Spokane, WA 99218-1257
Phone (509) 466-6393
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0207458 | Other | WA | L&I # |
| 8455214 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204156800000",
"number": "1013099035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "785 E HOLLAND AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992181257",
"telephone_number": "509-466-6393",
"fax_number": "509-466-5163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "785 E HOLLAND AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992181257",
"telephone_number": "509-466-6393",
"fax_number": "509-466-5163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANSON",
"first_name": "MICHAEL",
"middle_name": "DEAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2008-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00008637",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I #",
"identifier": "0207458",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8455214",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.