Healthcare Provider Details

I. General information

NPI: 1194518480
Provider Name (Legal Business Name): CARRIE NICHOLLE BEWS RN/ BSN/ IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 2ND AVE SW
QUINCY WA
98848-1773
US

IV. Provider business mailing address

1710 2ND AVE SW
QUINCY WA
98848-1773
US

V. Phone/Fax

Practice location:
  • Phone: 509-607-0959
  • Fax:
Mailing address:
  • Phone: 509-607-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberPENDING
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: