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General NPI Number Information
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NPI Number | 1093351850
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Entity Type | Organization
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Legal Business Name | STORK MIDWIFERY
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 1523 10TH ST
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City | MARYSVILLE
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State | WA
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Zip | 98270-4663
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Country | US
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Telephone | 425-350-1654
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Fax |
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Provider Business Mailing Address
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Address Line | 10720 130TH AVE NE
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City | LAKE STEVENS
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State | WA
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Zip | 98258-8878
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Country | US
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Telephone | 425-350-1654
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Fax |
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Authorized Official
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Title or Position | MIDWIFE
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Name | ELLENA KARPENKO
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Credential | LM, CPM, MSM
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Telephone | 425-350-1654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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