Healthcare Provider Details

I. General information

NPI: 1215088034
Provider Name (Legal Business Name): WOMANCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 LILLY RD NE BLDG B STE C
OLYMPIA WA
98506-5069
US

IV. Provider business mailing address

205 LILLY RD NE BLDG B STE C
OLYMPIA WA
98506-5069
US

V. Phone/Fax

Practice location:
  • Phone: 360-456-0555
  • Fax: 360-456-0721
Mailing address:
  • Phone: 360-456-0555
  • Fax: 360-456-0721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberRN00078685
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN00078685
License Number StateWA

VIII. Authorized Official

Name: MS. KAREN ELIZABETH SWIFT
Title or Position: CO-OWNER
Credential: A.R.N.P.
Phone: 360-456-0555