Provider Demographics
NPI:1972808988
Name:SWANSON, DAWN MARIE
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:SWANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11440 42ND AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-1370
Mailing Address - Country:US
Mailing Address - Phone:612-209-1527
Mailing Address - Fax:
Practice Address - Street 1:11440 42ND AVE N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-1370
Practice Address - Country:US
Practice Address - Phone:612-209-1527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath