Healthcare Provider Details

I. General information

NPI: 1033624820
Provider Name (Legal Business Name): DEBORAH KIRKPATRICK DOULA, MIDWIFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2017
Last Update Date: 12/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 BETHEL ST NE
OLYMPIA WA
98506-3304
US

IV. Provider business mailing address

1507 BETHEL ST NE
OLYMPIA WA
98506-3304
US

V. Phone/Fax

Practice location:
  • Phone: 503-893-8163
  • Fax:
Mailing address:
  • Phone: 503-893-8163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code176P00000X
TaxonomyFuneral Director
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: