Healthcare Provider Details
I. General information
NPI: 1306454434
Provider Name (Legal Business Name): RIVER CITY MIDWIFERY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2020
Last Update Date: 07/15/2020
Certification Date: 07/15/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13214 E MALLON CT
SPOKANE VALLEY WA
99216-1015
US
IV. Provider business mailing address
13214 E MALLON CT
SPOKANE VALLEY WA
99216-1015
US
V. Phone/Fax
- Phone: 509-850-0527
- Fax: 509-505-6277
- Phone: 509-850-0527
- Fax: 509-505-6277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 176B00000X |
| Taxonomy | Midwife |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIANA
HUISMAN
Title or Position: LICENSED MIDWIFE
Credential: LM, CPM
Phone: 509-850-0527