Provider Demographics
NPI:1760058275
Name:SWAIN, NAOMI (DO)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:SWAIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:BEEBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:603 S CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3875
Mailing Address - Country:US
Mailing Address - Phone:509-933-8693
Mailing Address - Fax:509-933-8694
Practice Address - Street 1:603 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3875
Practice Address - Country:US
Practice Address - Phone:509-933-8693
Practice Address - Fax:509-933-8694
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61331201207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2185953Medicaid