Provider Demographics
NPI:1023146883
Name:SWEM, ALTA D (LMP)
Entity type:Individual
Prefix:
First Name:ALTA
Middle Name:D
Last Name:SWEM
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16150 NE 85TH ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3539
Mailing Address - Country:US
Mailing Address - Phone:425-869-8779
Mailing Address - Fax:425-869-1724
Practice Address - Street 1:16150 NE 85TH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3539
Practice Address - Country:US
Practice Address - Phone:425-869-8779
Practice Address - Fax:425-869-1724
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA0003342174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist