Provider Demographics
NPI:1821683988
Name:GERTSCH, MARIA NICHOLE (CD (PALS))
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:NICHOLE
Last Name:GERTSCH
Suffix:
Gender:F
Credentials:CD (PALS)
Other - Prefix:MRS
Other - First Name:MIA
Other - Middle Name:NICHOLE
Other - Last Name:GERTSCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CD (PALS)
Mailing Address - Street 1:12236 NE 131ST WAY APT B104
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7327
Mailing Address - Country:US
Mailing Address - Phone:425-830-8338
Mailing Address - Fax:
Practice Address - Street 1:12236 NE 131ST WAY APT B104
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7327
Practice Address - Country:US
Practice Address - Phone:425-830-8338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA14094374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty