Healthcare Provider Details

I. General information

NPI: 1447198445
Provider Name (Legal Business Name): FERN INFANT FEEDING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 S UNION AVE STE B1
TACOMA WA
98405-1907
US

IV. Provider business mailing address

1310 S UNION AVE STE B1
TACOMA WA
98405-1907
US

V. Phone/Fax

Practice location:
  • Phone: 253-780-1700
  • Fax:
Mailing address:
  • Phone: 253-780-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: EMILY MANASSERO
Title or Position: OWNER / MIDWIFE
Credential: LM
Phone: 253-780-1700