Provider Demographics
NPI:1396972287
Name:SWANSON & SEEPERSAD CHIROPRACTIC, P.S.
Entity type:Organization
Organization Name:SWANSON & SEEPERSAD CHIROPRACTIC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-205-4592
Mailing Address - Street 1:3703 CALIFORNIA AVE SW
Mailing Address - Street 2:SUITE A/B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-3771
Mailing Address - Country:US
Mailing Address - Phone:206-937-3965
Mailing Address - Fax:206-937-4695
Practice Address - Street 1:3703 CALIFORNIA AVE SW
Practice Address - Street 2:SUITE A/B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-3771
Practice Address - Country:US
Practice Address - Phone:206-937-3965
Practice Address - Fax:206-937-4695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034682111N00000X
WACH00034667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty