Provider Demographics
NPI:1215088034
Name:WOMANCARE PLLC
Entity type:Organization
Organization Name:WOMANCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SWIFT
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:360-456-0555
Mailing Address - Street 1:205 LILLY RD NE
Mailing Address - Street 2:BLDG B STE C
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5069
Mailing Address - Country:US
Mailing Address - Phone:360-456-0555
Mailing Address - Fax:360-456-0721
Practice Address - Street 1:205 LILLY RD NE
Practice Address - Street 2:BLDG B STE C
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5069
Practice Address - Country:US
Practice Address - Phone:360-456-0555
Practice Address - Fax:360-456-0721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00078685176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9611112Medicaid
WAR96956Medicare UPIN
WAR31582Medicare UPIN