Provider Demographics
NPI:1992758486
Name:SWOFFORD & HALMA CLINIC, INC. P.S.
Entity type:Organization
Organization Name:SWOFFORD & HALMA CLINIC, INC. P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARLAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-837-3933
Mailing Address - Street 1:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944
Mailing Address - Country:US
Mailing Address - Phone:509-837-3933
Mailing Address - Fax:509-837-3885
Practice Address - Street 1:2303 REITH WAY
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944
Practice Address - Country:US
Practice Address - Phone:509-837-3933
Practice Address - Fax:509-837-3885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600135300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8156861Medicaid
WA8325193Medicaid
WA9632795Medicaid
WA8283707Medicaid
WAF49187Medicare UPIN
WA8283707Medicaid
WAAB10597Medicare ID - Type UnspecifiedDAVID J. SWOFFORD, D.O.
WA8156861Medicaid
WA9632795Medicaid
WAE17783Medicare UPIN
WAP47208Medicare UPIN