Provider Demographics
NPI:1447576095
Name:SWAIN, LINDY DANIELLE WOOD (PHARMD)
Entity type:Individual
Prefix:
First Name:LINDY
Middle Name:DANIELLE WOOD
Last Name:SWAIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:ILWACO
Mailing Address - State:WA
Mailing Address - Zip Code:98624-9100
Mailing Address - Country:US
Mailing Address - Phone:206-715-6801
Mailing Address - Fax:
Practice Address - Street 1:101 1ST AVE S
Practice Address - Street 2:
Practice Address - City:ILWACO
Practice Address - State:WA
Practice Address - Zip Code:98624-9100
Practice Address - Country:US
Practice Address - Phone:206-715-6801
Practice Address - Fax:509-474-2233
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH600865581835P0018X
WA60086558183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist