=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215088034
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOMANCARE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2007
-----------------------------------------------------
Last Update Date | 09/13/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 LILLY RD NE BLDG B STE C
-----------------------------------------------------
City | OLYMPIA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98506-5069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-456-0555
-----------------------------------------------------
Fax | 360-456-0721
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 205 LILLY RD NE BLDG B STE C
-----------------------------------------------------
City | OLYMPIA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98506-5069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-456-0555
-----------------------------------------------------
Fax | 360-456-0721
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER
-----------------------------------------------------
Name | MS. KAREN ELIZABETH SWIFT
-----------------------------------------------------
Credential | A.R.N.P.
-----------------------------------------------------
Telephone | 360-456-0555
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number | RN00078685
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number | RN00078685
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------