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General NPI Number Information
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NPI Number | 1598002933
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Entity Type | Organization
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Legal Business Name | BLUE MOUNTAIN MIDWIFERY & WOMEN'S HEALTH CARE
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Dates
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Enumeration Date | 01/04/2013
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 120 E BIRCH ST STE 7
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City | WALLA WALLA
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State | WA
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Zip | 99362-3054
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Country | US
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Telephone | 509-386-6985
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Fax | 509-876-4623
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Provider Business Mailing Address
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Address Line | 120 E BIRCH ST STE 7
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City | WALLA WALLA
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State | WA
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Zip | 99362-3054
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Country | US
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Telephone | 509-386-6985
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Fax | 509-876-4623
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KATHRYN JANE AUSTIN
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Credential | CNM ARNP
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Telephone | 509-386-6985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | AP 60039710
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License Number State | WA
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