Provider Demographics
NPI:1710604186
Name:MOTHERSHIP BIRTH CENTER PLLC
Entity Type:Organization
Organization Name:MOTHERSHIP BIRTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:360-808-3973
Mailing Address - Street 1:916 S 3RD ST STE B
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-4324
Mailing Address - Country:US
Mailing Address - Phone:360-808-3973
Mailing Address - Fax:360-826-8250
Practice Address - Street 1:916 S 3RD ST STE B
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-4324
Practice Address - Country:US
Practice Address - Phone:360-808-3973
Practice Address - Fax:360-826-8250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing