Provider Demographics
NPI:1750634424
Name:WHEATON, CAITLIN E (LM)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:E
Last Name:WHEATON
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16414 NE 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-3024
Mailing Address - Country:US
Mailing Address - Phone:406-370-8270
Mailing Address - Fax:
Practice Address - Street 1:4500 9TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4737
Practice Address - Country:US
Practice Address - Phone:206-659-5645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW60290264176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife