Individual
STACI H SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 116TH AVE NE STE 304, BELLEVUE, WA 98004-3057
(225) 715-5242
Mailing address
3509 184TH PL SE, BOTHELL, WA 98012-8846
(225) 715-5242
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP60408810
WA
Other
Enumeration date
08/19/2013
Last updated
08/07/2024
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