MEDICARE: LITTLE MOUNTAIN MIDWIFERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	MW60026404	WA

General Provider Information

NPI Number	:	1427492123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE MOUNTAIN MIDWIFERY

Provider Business Mailing Address
First Line	:	4125 ASHWORTH AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8147
Country	:	US
Telephone Number	:	206-618-8574
Fax Number	:	206-397-4473

Provider Business Practice Location Address
First Line	:	4125 ASHWORTH AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8147
Country	:	US
Telephone Number	:	206-618-8574
Fax Number	:	206-397-4473

Authorized Official
Title or Position	:	LICENSED MIDWIFE/ OWNER
Name	:	BEVERLY BROWNE SCHUBERT
Credential	:	LM, CPM
Telephone Number	:	206-618-8574

Provider Enumeration Date	:	04/24/2013
Last Update Date	:	04/24/2013

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