Provider Demographics
NPI:1174657811
Name:THE BIRTHING INN
Entity Type:Organization
Organization Name:THE BIRTHING INN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:253-686-3014
Mailing Address - Street 1:6002 WESTGATE BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-2580
Mailing Address - Country:US
Mailing Address - Phone:253-761-8939
Mailing Address - Fax:253-761-7492
Practice Address - Street 1:6002 WESTGATE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2580
Practice Address - Country:US
Practice Address - Phone:253-761-8939
Practice Address - Fax:253-761-7492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW60002237176B00000X
WACBC-023261Q00000X
WACBC.FS.60393769261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7098783Medicaid
WA7098783Medicaid