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General NPI Number Information
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NPI Number | 1770827099
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Entity Type | Organization
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Legal Business Name | CENTER FOR BIRTH MIDWIVES, LLC
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Dates
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Enumeration Date | 11/27/2012
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 1500 EASTLAKE AVE E
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City | SEATTLE
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State | WA
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Zip | 98102-3707
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Country | US
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Telephone | 206-407-3397
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 EASTLAKE AVE E
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City | SEATTLE
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State | WA
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Zip | 98102-3707
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Country | US
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Telephone | 206-407-3397
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. TINA TSIAKALIS
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Credential | LM, CPM
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Telephone | 206-407-3397
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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 | MW60095894
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License Number State | WA
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