Provider Demographics
NPI:1205801958
Name:HILLSON, BERNADETTE CLARA (CNM, ARNP)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:CLARA
Last Name:HILLSON
Suffix:
Gender:F
Credentials:CNM, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6002 N WESTGATE BLVD
Mailing Address - Street 2:STE 230
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-2572
Mailing Address - Country:US
Mailing Address - Phone:253-761-2244
Mailing Address - Fax:253-761-1040
Practice Address - Street 1:6002 N WESTGATE BLVD
Practice Address - Street 2:STE 230
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2572
Practice Address - Country:US
Practice Address - Phone:253-761-2244
Practice Address - Fax:253-761-1040
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004684176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0274870OtherL&I
WA9623646Medicaid
WAG8895727OtherMEDICARE