MEDICARE: DOULA TAB LLC

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	374J00000X	Doula

General Provider Information

NPI Number	:	1619730587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOULA TAB LLC

Provider Business Mailing Address
First Line	:	2607 S 360TH ST
Second Line	:
City	:	FEDERAL WAY
State	:	WA
Zip	:	98003-7105
Country	:	US
Telephone Number	:	619-370-3248
Fax Number	:

Provider Business Practice Location Address
First Line	:	2607 S 360TH ST
Second Line	:
City	:	FEDERAL WAY
State	:	WA
Zip	:	98003-7105
Country	:	US
Telephone Number	:	619-370-3248
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TABITHA LYNN
Credential	:
Telephone Number	:	619-370-3248

Provider Enumeration Date	:	02/02/2024
Last Update Date	:	04/17/2025

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Directions to “DOULA TAB LLC ” Practice Location

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