Healthcare Provider Details

I. General information

NPI: 1871052316
Provider Name (Legal Business Name): RACHEL MEREDITH MILHOLLAND LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 LAWRENCE ST
PORT TOWNSEND WA
98368-6526
US

IV. Provider business mailing address

1829 LINCOLN ST
PORT TOWNSEND WA
98368-7912
US

V. Phone/Fax

Practice location:
  • Phone: 360-316-9100
  • Fax:
Mailing address:
  • Phone: 360-316-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number18120014
License Number State
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW60926121
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: