1225478746 NPI number — KIMBERLEY BAUER NATUROPATHIC PHYSICIAN & MIDWIFE LLC

Table of content: (NPI 1225478746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225478746 NPI number — KIMBERLEY BAUER NATUROPATHIC PHYSICIAN & MIDWIFE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KIMBERLEY BAUER NATUROPATHIC PHYSICIAN & MIDWIFE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MIDWIVES OF LONDON HEALTH CENTER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225478746
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2513 LYNN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98225-2133
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-384-2900
Provider Business Mailing Address Fax Number:
360-384-2955

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2376 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE #3
Provider Business Practice Location Address City Name:
FERNDALE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98248-8605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-384-2900
Provider Business Practice Location Address Fax Number:
360-384-2955
Provider Enumeration Date:
06/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BAUER
Authorized Official First Name:
KIMBERLEY
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
360-384-2900

Provider Taxonomy Codes

  • Taxonomy code: 176B00000X , with the licence number:  MW00000322 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7144751 . This is a "DSHS HOMEBIRTH MIDWIFE PROVIDER ID NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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