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General NPI Number Information
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NPI Number | 1265258354
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Entity Type | Organization
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Legal Business Name | BIRTH PASSION MIDWIFERY, PLLC
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Dates
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Enumeration Date | 11/23/2024
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Last Update Date | 11/23/2024
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Provider Practice Location Address
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Address Line | 304 3RD ST SE
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City | YELM
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State | WA
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Zip | 98597-7640
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Country | US
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Telephone | 253-370-6987
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1265
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City | MCKENNA
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State | WA
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Zip | 98558-1265
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Country | US
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Telephone | 253-370-6987
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Fax | 253-248-0671
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | SHANNON RACHELLE SMITH
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Credential | LM
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Telephone | 253-370-6987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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