Provider Demographics
NPI:1891021861
Name:RAINY CITY MIDWIFERY
Entity Type:Organization
Organization Name:RAINY CITY MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:COYOTE
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:206-861-8300
Mailing Address - Street 1:222 10TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-5720
Mailing Address - Country:US
Mailing Address - Phone:206-861-8300
Mailing Address - Fax:206-861-8305
Practice Address - Street 1:222 10TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-5720
Practice Address - Country:US
Practice Address - Phone:206-861-8300
Practice Address - Fax:206-861-8305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00000064176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7019292Medicaid