1427479575 NPI number — GENTLE BIRTH CARE

Table of content: (NPI 1427479575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427479575 NPI number — GENTLE BIRTH CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GENTLE BIRTH CARE
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:
Provider Other Organization Name Type Code:
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:
1427479575
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
477 HORSESHOE BEND RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTERVILLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98613-2302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-322-6254
Provider Business Mailing Address Fax Number:
509-773-3041

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
477 HORSESHOE BEND RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTERVILLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98613-2302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-322-6254
Provider Business Practice Location Address Fax Number:
509-773-3041
Provider Enumeration Date:
12/16/2013

Additional Information

Authorized Official

Authorized Official Last Name:
TIPHARETH
Authorized Official First Name:
LAUREL
Authorized Official Middle Name:
SYLVAN
Authorized Official Title or Position:
OWNER/NURSE-MIDWIFE
Authorized Official Telephone Number:
509-322-6254

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1041343 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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