Healthcare Provider Details

I. General information

NPI: 1669246906
Provider Name (Legal Business Name): HANNAH RASMUSSEN CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 11/07/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 WASHINGTON AVE
ENUMCLAW WA
98022-3547
US

IV. Provider business mailing address

1108 WASHINGTON AVE
ENUMCLAW WA
98022-3547
US

V. Phone/Fax

Practice location:
  • Phone: 208-960-5619
  • Fax: 206-430-6227
Mailing address:
  • Phone: 208-960-5619
  • Fax: 206-430-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCPM23090321
License Number State

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: