Provider Demographics
NPI:1811445141
Name:NURTURING EXPRESSIONS LLC
Entity type:Organization
Organization Name:NURTURING EXPRESSIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO, CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:COREY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC, CFM
Authorized Official - Phone:206-763-2733
Mailing Address - Street 1:PO BOX 47163
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146-7163
Mailing Address - Country:US
Mailing Address - Phone:206-763-2733
Mailing Address - Fax:206-763-2122
Practice Address - Street 1:19950 7TH AVE NE SUITE 102
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-4476
Practice Address - Country:US
Practice Address - Phone:360-930-0218
Practice Address - Fax:360-930-8383
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NURTURING EXPRESSIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-15
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WL0100X, 174N00000X
WA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9055575Medicaid
WA6708100001Medicare UPIN