Healthcare Provider Details

I. General information

NPI: 1265701171
Provider Name (Legal Business Name): JESSICA A TABAKIN NAPS DOULAS, CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2011
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 29TH AVE S APT 2
SEATTLE WA
98144-3152
US

IV. Provider business mailing address

836 29TH AVE S APT 2
SEATTLE WA
98144-3152
US

V. Phone/Fax

Practice location:
  • Phone: 206-293-4472
  • Fax:
Mailing address:
  • Phone: 206-293-4472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number603089921
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: