Provider Demographics
NPI:1174177075
Name:SWIDERSKI, LAUREN (MT-BC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SWIDERSKI
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 13TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-2542
Mailing Address - Country:US
Mailing Address - Phone:206-556-5662
Mailing Address - Fax:
Practice Address - Street 1:316 S I ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4212
Practice Address - Country:US
Practice Address - Phone:206-556-5662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist