MEDICARE: TERRI LYNN YOUNG C.P.M., L.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	MID-42	ID

General Provider Information

NPI Number	:	1851666184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI LYNN YOUNG C.P.M., L.M.

Provider Business Mailing Address
First Line	:	18707 E JACKSON DR
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99027-9524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18707 E JACKSON DR
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99027-9524
Country	:	US
Telephone Number	:	208-964-5268
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2012
Last Update Date	:	03/20/2012

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