Healthcare Provider Details

I. General information

NPI: 1174657811
Provider Name (Legal Business Name): THE BIRTHING INN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 WESTGATE BLVD STE 120
TACOMA WA
98406-2580
US

IV. Provider business mailing address

6002 WESTGATE BLVD STE 120
TACOMA WA
98406-2580
US

V. Phone/Fax

Practice location:
  • Phone: 253-761-8939
  • Fax: 253-761-7492
Mailing address:
  • Phone: 253-761-8939
  • Fax: 253-761-7492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW60002237
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberCBC-023
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberCBC.FS.60393769
License Number StateWA

VIII. Authorized Official

Name: MS. SUSAN J SHERWOOD
Title or Position: OWNER
Credential: LM, CPM
Phone: 253-686-3014