Provider Demographics
NPI:1184126393
Name:DEMARCO, GLORIA MAE (LICENSED MIDWIFE)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:MAE
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:LICENSED MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1820
Mailing Address - Country:US
Mailing Address - Phone:715-410-6973
Mailing Address - Fax:
Practice Address - Street 1:302 W ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1820
Practice Address - Country:US
Practice Address - Phone:715-410-6973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-03
Last Update Date:2018-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW60821442176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife