Healthcare Provider Details

I. General information

NPI: 1831012228
Provider Name (Legal Business Name): HANNA KIRSTI PETRY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34509 9TH AVE S STE 207
FEDERAL WAY WA
98003-8709
US

IV. Provider business mailing address

14511 46TH AVENUE CT NW
GIG HARBOR WA
98332-8030
US

V. Phone/Fax

Practice location:
  • Phone: 253-815-9595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP70080202
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: