Healthcare Provider Details

I. General information

NPI: 1568868651
Provider Name (Legal Business Name): ERIN O. COGHLAN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2014
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9245 RAINIER AVE S
SEATTLE WA
98118-5569
US

IV. Provider business mailing address

1200 12TH AVE S SUITE 901
SEATTLE WA
98144-2712
US

V. Phone/Fax

Practice location:
  • Phone: 206-722-8444
  • Fax: 206-721-6310
Mailing address:
  • Phone: 206-548-3114
  • Fax: 206-762-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN60740857
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP60742542
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF001652
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: