Provider Demographics
NPI:1801631809
Name:SWANSON, SHERMAN MERLE III
Entity type:Individual
Prefix:
First Name:SHERMAN
Middle Name:MERLE
Last Name:SWANSON
Suffix:III
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2151
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-2151
Mailing Address - Country:US
Mailing Address - Phone:253-810-7879
Mailing Address - Fax:
Practice Address - Street 1:1391 G ST
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-5820
Practice Address - Country:US
Practice Address - Phone:707-273-6922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA156301106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist