Provider Demographics
NPI:1366433203
Name:SWARTS, CARL E (DC)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:E
Last Name:SWARTS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:BORING
Mailing Address - State:OR
Mailing Address - Zip Code:97009-0909
Mailing Address - Country:US
Mailing Address - Phone:503-668-5822
Mailing Address - Fax:503-668-3662
Practice Address - Street 1:17500 STRAUSS AVE
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-8060
Practice Address - Country:US
Practice Address - Phone:503-668-5822
Practice Address - Fax:503-668-3662
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000QGHBBMedicare PIN
ORU50788Medicare UPIN