Healthcare Provider Details

I. General information

NPI: 1669390902
Provider Name (Legal Business Name): WOMB WITHIN COLLECTIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 STATESMAN ST
WALLA WALLA WA
99362-3455
US

IV. Provider business mailing address

816 STATESMAN ST
WALLA WALLA WA
99362-3455
US

V. Phone/Fax

Practice location:
  • Phone: 509-301-0523
  • Fax:
Mailing address:
  • Phone: 509-301-0523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: JESSICA NELSON
Title or Position: CO-OWNER
Credential:
Phone: 509-301-0523