Healthcare Provider Details

I. General information

NPI: 1316084940
Provider Name (Legal Business Name): HEATHER MARIE CHORLEY LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3830 S FERDINAND ST
SEATTLE WA
98118-1738
US

IV. Provider business mailing address

3830 S FERDINAND ST
SEATTLE WA
98118-1738
US

V. Phone/Fax

Practice location:
  • Phone: 206-722-3426
  • Fax: 206-722-3459
Mailing address:
  • Phone: 206-722-3426
  • Fax: 206-722-3459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW00000218
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: