=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467123075
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YAMHILL VALLEY COMMUNITY DOULAS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2021
-----------------------------------------------------
Last Update Date | 09/23/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 640 NE 3RD ST
-----------------------------------------------------
City | MCMINNVILLE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97128-4630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-583-2607
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 345 NE KINGWOOD ST
-----------------------------------------------------
City | MCMINNVILLE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97128-9029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-583-2607
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-FOUNDING DIRECTOR
-----------------------------------------------------
Name | ALYSON LARKIN
-----------------------------------------------------
Credential | THW, CD
-----------------------------------------------------
Telephone | 503-583-2607
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------