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Individual

DR. KELSI JEANETTE JORE SWANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2819 GREAT NORTHERN LOOP STE 200, MISSOULA, MT 59808-1750
(406) 542-7525
(406) 829-0661
Mailing address
PO BOX 7817, MISSOULA, MT 59807-7817
(406) 542-7525
(406) 829-0661

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
73654
MT
208600000X
Surgery Physician
MD481377
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15957727
CAQH
Enumeration date
04/05/2018
Last updated
10/11/2024
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