MEDICARE: CATHERINE MARY O'BRIEN CNM

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	367A00000X	Advanced Practice Midwife		WA
2	367A00000X	Advanced Practice Midwife
3	367A00000X	Advanced Practice Midwife	AP60635031	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871830125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE MARY O'BRIEN CNM

Provider Business Mailing Address
First Line	:	620 NW 11TH ST STE M106
Second Line	:
City	:	HERMISTON
State	:	OR
Zip	:	97838-6941
Country	:	US
Telephone Number	:	541-289-4118
Fax Number	:	541-667-3484

Provider Business Practice Location Address
First Line	:	853 WATSON ST N STE 200
Second Line	:
City	:	ENUMCLAW
State	:	WA
Zip	:	98022-3948
Country	:	US
Telephone Number	:	360-367-2970
Fax Number	:

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

Provider Enumeration Date	:	01/07/2013
Last Update Date	:	02/11/2023

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