Provider Demographics
NPI:1306056742
Name:FIRSTLIGHT MIDWIFERY CARE PC
Entity type:Organization
Organization Name:FIRSTLIGHT MIDWIFERY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:RACHELLE
Authorized Official - Last Name:WADLEIGH
Authorized Official - Suffix:
Authorized Official - Credentials:LM CPM
Authorized Official - Phone:253-973-9926
Mailing Address - Street 1:401 BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-3900
Mailing Address - Country:US
Mailing Address - Phone:253-973-9926
Mailing Address - Fax:253-627-5411
Practice Address - Street 1:401 BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3900
Practice Address - Country:US
Practice Address - Phone:253-973-9926
Practice Address - Fax:253-627-5411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty