Provider Demographics
NPI:1942862792
Name:SOUND BIRTH SERVICES LLC DBA PENINSULA MIDWIVES
Entity Type:Organization
Organization Name:SOUND BIRTH SERVICES LLC DBA PENINSULA MIDWIVES
Other - Org Name:PENINSULA MIDWIVES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MIDWIFE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORROCKS
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:360-385-6667
Mailing Address - Street 1:PO BOX 1660
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368
Mailing Address - Country:US
Mailing Address - Phone:360-385-6667
Mailing Address - Fax:360-841-7750
Practice Address - Street 1:1001 WATER ST
Practice Address - Street 2:SUITE 1015
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368
Practice Address - Country:US
Practice Address - Phone:360-385-6667
Practice Address - Fax:360-841-7750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2138746Medicaid