Provider Demographics
NPI:1154195543
Name:SWERDLOFF, KAMILA (MT-BC)
Entity type:Individual
Prefix:
First Name:KAMILA
Middle Name:
Last Name:SWERDLOFF
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 1:1087 11TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-4100
Mailing Address - Country:US
Mailing Address - Phone:503-440-9761
Mailing Address - Fax:
Practice Address - Street 1:1087 11TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-4100
Practice Address - Country:US
Practice Address - Phone:503-440-9761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
17319225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist