Provider Demographics
NPI:1033832126
Name:MILES, NATALIE (IBCLC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7708 BRETHERTON AVE NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-6286
Mailing Address - Country:US
Mailing Address - Phone:802-503-7694
Mailing Address - Fax:
Practice Address - Street 1:2727 WESTMOOR CT SW STE 100
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5754
Practice Address - Country:US
Practice Address - Phone:360-227-1769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAL-136802174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN