Provider Demographics
NPI:1366923120
Name:ORIGINS NATURAL HEALTH AND MIDWIFERY
Entity type:Organization
Organization Name:ORIGINS NATURAL HEALTH AND MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HURD
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LM, CPM
Authorized Official - Phone:360-862-2005
Mailing Address - Street 1:110 CEDAR AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2959
Mailing Address - Country:US
Mailing Address - Phone:360-282-4024
Mailing Address - Fax:360-282-4017
Practice Address - Street 1:110 CEDAR AVE APT 101
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2959
Practice Address - Country:US
Practice Address - Phone:360-282-4014
Practice Address - Fax:360-282-4017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW60402527176B00000X
WANT60408970175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1356779151Medicaid