Active NPI
Carl Swanstrom, PHD
- Psychologist
- Covington, WA
National Provider Identifier
1295891232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY00000730
- Practice address
- 27121 174TH PL SE Ste 100
Covington, WA 98042-4939 - Phone
- (253) 638-8547
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY00000730 | WA | Primary |
Addresses
Primary practice location
27121 174TH PL SE Ste 100
Covington, WA 98042-4939
Mailing address
27121 174TH PL SE Ste 100
Covington, WA 98042-4939
Phone (253) 638-8547
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00000730 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269388800000",
"number": "1295891232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27121 174TH PL SE STE 100",
"city": "COVINGTON",
"state": "WA",
"postal_code": "980424939",
"telephone_number": "253-638-8547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27121 174TH PL SE STE 100",
"city": "COVINGTON",
"state": "WA",
"postal_code": "980424939",
"telephone_number": "253-638-8547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANSTROM",
"first_name": "CARL",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2010-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY00000730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.