Provider Demographics
NPI:1396296943
Name:ELAINE ARNOLD LM CPM
Entity type:Organization
Organization Name:ELAINE ARNOLD LM CPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:B.
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:LM CPM
Authorized Official - Phone:425-344-7703
Mailing Address - Street 1:PO BX 1127
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057
Mailing Address - Country:US
Mailing Address - Phone:425-344-7703
Mailing Address - Fax:425-277-9272
Practice Address - Street 1:320 RENTON AVE S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-6016
Practice Address - Country:US
Practice Address - Phone:425-344-7703
Practice Address - Fax:425-277-9272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW60691309261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing