Healthcare Provider Details

I. General information

NPI: 1205801958
Provider Name (Legal Business Name): BERNADETTE CLARA HILLSON CNM, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 N WESTGATE BLVD STE 230
TACOMA WA
98406-2572
US

IV. Provider business mailing address

6002 N WESTGATE BLVD STE 230
TACOMA WA
98406-2572
US

V. Phone/Fax

Practice location:
  • Phone: 253-761-2244
  • Fax: 253-761-1040
Mailing address:
  • Phone: 253-761-2244
  • Fax: 253-761-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberAP30004684
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP30004684
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: