Healthcare Provider Details

I. General information

NPI: 1700944709
Provider Name (Legal Business Name): CATHLEEN WESTON CPM,RN,LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16660 N RIGHT FORK RD
HAUSER ID
83854-5585
US

IV. Provider business mailing address

PO BOX 966
NEWMAN LAKE WA
99025-0966
US

V. Phone/Fax

Practice location:
  • Phone: 208-773-9420
  • Fax: 208-773-5776
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number60050144
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: