Provider Demographics
NPI:1144671629
Name:SWOPE, KERIANN A (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:KERIANN
Middle Name:A
Last Name:SWOPE
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22015 SE 358TH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-9019
Mailing Address - Country:US
Mailing Address - Phone:206-387-5936
Mailing Address - Fax:
Practice Address - Street 1:3045 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-3301
Practice Address - Country:US
Practice Address - Phone:206-387-5936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60597875171100000X
WANT60606638175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist