Basic Information
Provider Information
NPI: 1700882875
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SWEGLE
FirstName: JAMES
MiddleName: H.
NamePrefix: MR.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1400 E KINCAID ST
Address2: ATTN: CREDENTIALING
City: MOUNT VERNON
State: WA
PostalCode: 982744127
CountryCode: US
TelephoneNumber: 3604282500
FaxNumber: 3604286485
Practice Location
Address1: 208 S. 14TH STREET
Address2: SKAGIT VALLEY HOSPITAL - WOUND HEALING CENTER
City: MOUNT VERNON
State: WA
PostalCode: 98274
CountryCode: US
TelephoneNumber: 3608142600
FaxNumber: 3608148390
Other Information
ProviderEnumerationDate: 06/23/2005
LastUpdateDate: 07/14/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP30001783WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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