Provider Demographics
NPI:1346664588
Name:FULLCIRCLE
Entity Type:Organization
Organization Name:FULLCIRCLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BIRTH DOULA
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUKTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-779-1232
Mailing Address - Street 1:106 MADRONA PL E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5010
Mailing Address - Country:US
Mailing Address - Phone:206-779-1232
Mailing Address - Fax:
Practice Address - Street 1:106 MADRONA PL E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5010
Practice Address - Country:US
Practice Address - Phone:206-779-1232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA11302F00000X
WA374J00000X305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
No302F00000XManaged Care OrganizationsExclusive Provider Organization