Provider Demographics
NPI:1003382128
Name:VANCOUVER COMMUNITY MIDWIVES, PLLC
Entity Type:Organization
Organization Name:VANCOUVER COMMUNITY MIDWIVES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CALLAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:360-719-0208
Mailing Address - Street 1:1901 NW 92ND ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-6628
Mailing Address - Country:US
Mailing Address - Phone:360-719-0208
Mailing Address - Fax:360-859-1609
Practice Address - Street 1:1901 NW 92ND ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-6628
Practice Address - Country:US
Practice Address - Phone:360-719-0208
Practice Address - Fax:360-859-1609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty