Healthcare Provider Details

I. General information

NPI: 1205784675
Provider Name (Legal Business Name): BLACK BIRTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BROADWAY
TACOMA WA
98402-3900
US

IV. Provider business mailing address

401 BROADWAY
TACOMA WA
98402-3900
US

V. Phone/Fax

Practice location:
  • Phone: 253-444-4997
  • Fax:
Mailing address:
  • Phone: 253-444-4997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name: STARLENE HOWARD
Title or Position: OWNER
Credential:
Phone: 253-444-4997