=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316744477
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JODIE LYNN SOLBERG CHT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2025
-----------------------------------------------------
Last Update Date | 07/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7558 PRESSENTIN RANCH DR
-----------------------------------------------------
City | CONCRETE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98237-8803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-608-1867
-----------------------------------------------------
Fax | 425-845-2375
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 247
-----------------------------------------------------
City | CONCRETE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98237-0247
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-608-1867
-----------------------------------------------------
Fax | 425-845-2375
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174H00000X
-----------------------------------------------------
Taxonomy Name | Health Educator
-----------------------------------------------------
License Number | HP61019271
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number | BDC.BD.70032267
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | HP61019271
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------