Provider Demographics
NPI: | 1083389365 |
---|---|
Name: | COLUMBIA BIRTH CARE, LLC |
Entity type: | Organization |
Organization Name: | COLUMBIA BIRTH CARE, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CYNTHIA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FLYNN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 206-450-2753 |
Mailing Address - Street 1: | 948 STEVENS DR STE B |
Mailing Address - Street 2: | |
Mailing Address - City: | RICHLAND |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 99352-3547 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 948 STEVENS DR STE B |
Practice Address - Street 2: | |
Practice Address - City: | RICHLAND |
Practice Address - State: | WA |
Practice Address - Zip Code: | 99352-3547 |
Practice Address - Country: | US |
Practice Address - Phone: | 206-450-2753 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-08-10 |
Last Update Date: | 2021-08-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | Group - Multi-Specialty | |
No | 176B00000X | Other Service Providers | Midwife | Group - Multi-Specialty |