Healthcare Provider Details

I. General information

NPI: 1871716324
Provider Name (Legal Business Name): SPOKANE MIDWIVES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 01/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 E. EUCLID AVE
SPOKANE WA
99207-2022
US

IV. Provider business mailing address

127 E. EUCLID AVE
SPOKANE WA
99207-2022
US

V. Phone/Fax

Practice location:
  • Phone: 509-326-4366
  • Fax: 509-328-9266
Mailing address:
  • Phone: 509-326-4366
  • Fax: 509-328-9266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW00000174
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW00000229
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License NumberCBC-025
License Number StateWA

VIII. Authorized Official

Name: VICTORIA STICKELMEYER
Title or Position: OWNER/PARTNER
Credential: CPM, LM
Phone: 509-326-4366