Virginia E Swanson, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD00048778 Issued in WA

Practice address

17791 Fjord Dr NE
Suite 110
Poulsbo, WA 98370-8481

Phone

(360) 626-9034

Fax

(360) 626-9046

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1508875865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983700012",
            "telephone_number": "360-626-9034",
            "fax_number": "360-626-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17791 FJORD DR NE",
            "address_2": "SUITE 110",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708481",
            "telephone_number": "360-626-9034",
            "fax_number": "360-626-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "VIRGINIA",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00048778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1117720",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "610902800",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF L&I",
            "identifier": "163901",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunrise Dental
• Sunrise Dental
• Rachael Lee Svenson, SUDPT CO61625586
• Svetlana Swan, ARNP
• Erik William Swanson, LMP
• Linda Diane Swartz, M.D.
• Angela Nichole Szatkowski, D.O.
• Jack Ronald Tacker, M.D.
• Shannon June Tallon, MA
• Richard H. Tangen, DDS

• Physical Medicine & Rehabilitation Physician in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.