Provider Demographics
NPI:1326641341
Name:WELLSPRING MIDWIFERY LLC
Entity Type:Organization
Organization Name:WELLSPRING MIDWIFERY LLC
Other - Org Name:WELLSPRING MIDWIFERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FAY
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:253-313-1031
Mailing Address - Street 1:34617 11TH PL S STE 201
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8706
Mailing Address - Country:US
Mailing Address - Phone:253-313-1031
Mailing Address - Fax:253-393-5443
Practice Address - Street 1:34617 11TH PL S STE 201
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8706
Practice Address - Country:US
Practice Address - Phone:253-313-1031
Practice Address - Fax:253-393-5443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-20
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty