Provider Demographics
NPI:1003271057
Name:LOVE THE BELLY MIDWIFERY & WOMEN'S HEALTH, LLC
Entity type:Organization
Organization Name:LOVE THE BELLY MIDWIFERY & WOMEN'S HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, CNM
Authorized Official - Phone:253-376-9070
Mailing Address - Street 1:PO BOX 734
Mailing Address - Street 2:
Mailing Address - City:FOX ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98333-0734
Mailing Address - Country:US
Mailing Address - Phone:253-376-9070
Mailing Address - Fax:253-248-0149
Practice Address - Street 1:5224 OLYMPIC DR NW STE 106
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1792
Practice Address - Country:US
Practice Address - Phone:253-376-9070
Practice Address - Fax:253-248-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACNM1646364SW0102X
WAAP60424955363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2034218Medicaid