Healthcare Provider Details

I. General information

NPI: 1437531324
Provider Name (Legal Business Name): JANMODAYA MIDWIFERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2015
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3518 FREMONT AVE N #435
SEATTLE WA
98103-8814
US

IV. Provider business mailing address

3518 FREMONT AVE N #435
SEATTLE WA
98103-8814
US

V. Phone/Fax

Practice location:
  • Phone: 425-243-4715
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberRN60238014
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberAP60518676
License Number StateWA

VIII. Authorized Official

Name: AMITA SREENIVAS
Title or Position: FOUNDER
Credential: DNP, MPH, CNM, ARNP
Phone: 425-243-4715