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General NPI Number Information
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NPI Number | 1851517759
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Entity Type | Individual
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Provider Name | DESIREE LYNN LEFAVE CPM, LDM
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 114 E HANCOCK ST
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City | NEWBERG
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State | OR
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Zip | 97132-2822
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Country | US
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Telephone | 503-538-1033
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Fax | 503-538-1033
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Provider Business Mailing Address
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Address Line | 408 S CENTER ST
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City | NEWBERG
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State | OR
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Zip | 97132-3553
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Country | US
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Telephone | 503-537-6127
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Fax | 503-538-1033
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175M00000X
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Taxonomy Name | Lay Midwife
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License Number | DEM-LD-842083
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License Number State | OR
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