Healthcare Provider Details

I. General information

NPI: 1548681414
Provider Name (Legal Business Name): DULCE BIRTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2013
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17321 18TH AVE SE
BOTHELL WA
98012-6482
US

IV. Provider business mailing address

17321 18TH AVE SE
BOTHELL WA
98012-6482
US

V. Phone/Fax

Practice location:
  • Phone: 206-234-9267
  • Fax:
Mailing address:
  • Phone: 206-234-9267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number603253941
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number603253941
License Number StateWA

VIII. Authorized Official

Name: MA GUADALUPE VALTIERRA PRIETO
Title or Position: OWNER
Credential:
Phone: 206-234-9267