1609449800 NPI number — MRS. DOMINIQUE HANNAH SWARTZ RN

Table of content: MRS. DOMINIQUE HANNAH SWARTZ RN (NPI 1609449800)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609449800 NPI number — MRS. DOMINIQUE HANNAH SWARTZ RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SWARTZ
Provider First Name:
DOMINIQUE
Provider Middle Name:
HANNAH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PAPILLON
Provider Other First Name:
DOMINIQUE
Provider Other Middle Name:
HANNAH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609449800
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1377 BARTLETT CT NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVERDALE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98383-8933
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-471-0576
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1377 BARTLETT CT NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILVERDALE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98383-8933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-471-0576
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/23/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WC1500X , with the licence number:  RN61070919 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)