Provider Demographics
NPI:1184226441
Name:DUCKWORTH, AUTUMN RENE (RD, CD(DONA), CLC)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:RENE
Last Name:DUCKWORTH
Suffix:
Gender:F
Credentials:RD, CD(DONA), CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12054 NE 137TH CT
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2122
Mailing Address - Country:US
Mailing Address - Phone:425-260-9863
Mailing Address - Fax:
Practice Address - Street 1:12054 NE 137TH CT
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-2122
Practice Address - Country:US
Practice Address - Phone:425-260-9863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula