Provider Demographics
NPI:1336855733
Name:WILD WOMB MIDWIFERY, PLLC
Entity type:Organization
Organization Name:WILD WOMB MIDWIFERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:BRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:509-703-3644
Mailing Address - Street 1:2314 N CHERRY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1152
Mailing Address - Country:US
Mailing Address - Phone:509-850-0527
Mailing Address - Fax:509-505-6277
Practice Address - Street 1:2314 N CHERRY ST STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1152
Practice Address - Country:US
Practice Address - Phone:509-850-0527
Practice Address - Fax:509-505-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty