Basic Information
| Provider Information | |||||||||
| NPI: | 1154766962 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWISS | ||||||||
| FirstName: | NATHAN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 94625 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981246925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4254071000 | ||||||||
| FaxNumber: | 4254071112 | ||||||||
| Practice Location | |||||||||
| Address1: | 413 LILLY RD NE | ||||||||
| Address2: | |||||||||
| City: | OLYMPIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985065133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604919480 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2013 | ||||||||
| LastUpdateDate: | 10/16/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | OP60834239 | WA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 390200000X | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.