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General NPI Number Information
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NPI Number | 1831431170
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Entity Type | Organization
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Legal Business Name | HEALTHY WOMAN SEATTLE
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Dates
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Enumeration Date | 03/25/2013
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Last Update Date | 03/25/2013
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Provider Practice Location Address
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Address Line | 8401 5TH AVE NE STE 102
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City | SEATTLE
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State | WA
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Zip | 98115-4171
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Country | US
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Telephone | 425-366-7563
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Fax |
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Provider Business Mailing Address
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Address Line | 2511 NE 100TH ST
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City | SEATTLE
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State | WA
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Zip | 98125-7707
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Country | US
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Telephone | 425-366-7563
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA DEARDORFF
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Credential | CNM ARNP
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Telephone | 626-905-9210
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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 | AP60239525
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License Number State | WA
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