Provider Demographics
NPI:1447844261
Name:SWANSON, KARIN (LMT)
Entity type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:
Last Name:SWANSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 BOUNTY DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3730
Mailing Address - Country:US
Mailing Address - Phone:801-699-5735
Mailing Address - Fax:
Practice Address - Street 1:12570 OLD SEWARD HWY STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3532
Practice Address - Country:US
Practice Address - Phone:907-333-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK169013225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist