=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538459136
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GROWING FAMILY BIRTH CENTER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2011
-----------------------------------------------------
Last Update Date | 02/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 701 N 5TH ST UNIT B1010
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97355-0087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-259-2500
-----------------------------------------------------
Fax | 541-203-9449
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 701 N 5TH ST UNIT B1010
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97355-0087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-259-2500
-----------------------------------------------------
Fax | 541-203-9449
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER / MIDWIFE
-----------------------------------------------------
Name | DEBRA A COWART
-----------------------------------------------------
Credential | CPM, LDM
-----------------------------------------------------
Telephone | 541-259-2500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QB0400X
-----------------------------------------------------
Taxonomy Name | Birthing Clinic/Center
-----------------------------------------------------
License Number | 071613
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------