Provider Demographics
NPI:1588877559
Name:SWARZTRAUBER, KARLEEN (MD)
Entity type:Individual
Prefix:
First Name:KARLEEN
Middle Name:
Last Name:SWARZTRAUBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:
Other - Last Name:SWARZTRAUBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672-0037
Mailing Address - Country:US
Mailing Address - Phone:503-816-2959
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 37
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672-0037
Practice Address - Country:US
Practice Address - Phone:503-783-3090
Practice Address - Fax:503-636-1284
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD227242084N0400X
WAMD604180232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR288029Medicaid
ORG02208Medicare UPIN
OR139828Medicare PIN