Provider Demographics
NPI:1699538496
Name:FEDERAL WAY BIRTH CENTER
Entity type:Organization
Organization Name:FEDERAL WAY BIRTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FAISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAROLE
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:206-683-8167
Mailing Address - Street 1:2740 SW 342ND ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-7609
Mailing Address - Country:US
Mailing Address - Phone:206-683-8167
Mailing Address - Fax:
Practice Address - Street 1:2319 SW 320TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2514
Practice Address - Country:US
Practice Address - Phone:206-683-8167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing