Virginia E Swanson MD PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD00040778 Issued in WA

Legal business name

VIRGINIA E SWANSON MD PLLC

Practice address

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

Phone

(360) 626-9034

Fax

(360) 626-9046

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Virginia E Swanson, MD

Title

Owner

Phone

(360) 626-9034

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1629138631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": {
        "organization_name": "VIRGINIA E SWANSON MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-626-9034",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00040778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1117720",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF L&I",
            "identifier": "163901",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "610902800",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.