=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194347898
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAMILA HELLMEISTER LM, CPM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2020
-----------------------------------------------------
Last Update Date | 08/09/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22725 44TH AVE W STE 101
-----------------------------------------------------
City | MOUNTLAKE TERRACE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98043-4500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-678-9070
-----------------------------------------------------
Fax | 425-420-2941
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 22725 44TH AVE W STE 101
-----------------------------------------------------
City | MOUNTLAKE TERRACE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98043-4500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-678-9070
-----------------------------------------------------
Fax | 425-420-2941
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number | MW.60872457
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------