Healthcare Provider Details

I. General information

NPI: 1245605757
Provider Name (Legal Business Name): THE BIRTHING INN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2015
Last Update Date: 12/09/2015
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:
Mailing address:
  • Phone: 253-761-8939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW60386592
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

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