Healthcare Provider Details

I. General information

NPI: 1720236946
Provider Name (Legal Business Name): BELLIES, BABIES & BREASTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2008
Last Update Date: 08/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11604 NE 185TH ST
BATTLE GROUND WA
98604-7374
US

IV. Provider business mailing address

11604 NE 185TH ST
BATTLE GROUND WA
98604-7374
US

V. Phone/Fax

Practice location:
  • Phone: 360-798-6243
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State

VIII. Authorized Official

Name: KAREN P. ROESKE
Title or Position: PRESIDENT
Credential: RN, IBCLC
Phone: 360-798-6243