Healthcare Provider Details

I. General information

NPI: 1669799029
Provider Name (Legal Business Name): REBECCA BRICKER THW BIRTH DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BECKY BRICKER THW BIRTH DOULA

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 S. 19TH STREET
PHILOMATH OR
97370
US

IV. Provider business mailing address

PO BOX 1502
PHILOMATH OR
97370-1502
US

V. Phone/Fax

Practice location:
  • Phone: 541-929-4518
  • Fax:
Mailing address:
  • Phone: 541-602-0345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number970
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: