Individual
RUSSELL CRAIG SWENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3928 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-1558
Mailing address
4316 CRYSTAL LANE LOOP SE, PUYALLUP, WA 98372-5293
(253) 841-1191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5680
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5031182
DSHS
WA
Enumeration date
02/02/2007
Last updated
07/08/2007
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