Individual
MR. EDWARD SWENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3927 RUCKER AVE, EVERETT, WA 98201-4833
(425) 339-5422
(425) 339-5444
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 339-5422
(425) 339-5444
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003311
WA
363AM0700X
Medical Physician Assistant
PA100003311
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005545
—
WA
Enumeration date
03/03/2006
Last updated
11/15/2019
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