Provider Demographics
NPI:1477899276
Name:FREMONT MIDWIFERY
Entity Type:Organization
Organization Name:FREMONT MIDWIFERY
Other - Org Name:GERALDINE LEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR/MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:206-818-1321
Mailing Address - Street 1:3902 WHITMAN AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-7824
Mailing Address - Country:US
Mailing Address - Phone:206-818-1321
Mailing Address - Fax:206-400-2739
Practice Address - Street 1:4428 BURKE AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7536
Practice Address - Country:US
Practice Address - Phone:206-818-1321
Practice Address - Fax:206-400-2739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW00000306176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty