Healthcare Provider Details

I. General information

NPI: 1740310309
Provider Name (Legal Business Name): MARGARET ANNE THURSTON LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PEGGY THURSTON LM

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11698 NE SUNSET LOOP
BAINBRIDGE ISLAND WA
98110-4290
US

IV. Provider business mailing address

PO BOX 1354
SUQUAMISH WA
98392-1354
US

V. Phone/Fax

Practice location:
  • Phone: 360-598-4727
  • Fax:
Mailing address:
  • Phone: 360-598-4727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW00000208
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: