Provider Demographics
NPI:1093351850
Name:STORK MIDWIFERY
Entity type:Organization
Organization Name:STORK MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:ELLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARPENKO
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM, MSM
Authorized Official - Phone:425-350-1654
Mailing Address - Street 1:10720 130TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-8878
Mailing Address - Country:US
Mailing Address - Phone:425-350-1654
Mailing Address - Fax:
Practice Address - Street 1:1523 10TH ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4663
Practice Address - Country:US
Practice Address - Phone:425-350-1654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health