Provider Demographics
NPI:1598974446
Name:SWORD, SUSAN (LMP, DOULA, REFLE)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:SWORD
Suffix:
Gender:F
Credentials:LMP, DOULA, REFLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 E 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-3562
Mailing Address - Country:US
Mailing Address - Phone:509-532-0675
Mailing Address - Fax:
Practice Address - Street 1:2028 E 14TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-3562
Practice Address - Country:US
Practice Address - Phone:509-532-0675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00005777174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA#00005777OtherLICENSED MASSAGE THERAPY