Provider Demographics
NPI:1295875227
Name:WADLEIGH, DAWN RACHELLE (LM, CPM)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:RACHELLE
Last Name:WADLEIGH
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-3900
Mailing Address - Country:US
Mailing Address - Phone:253-973-9926
Mailing Address - Fax:253-627-5411
Practice Address - Street 1:401 BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3900
Practice Address - Country:US
Practice Address - Phone:253-973-9926
Practice Address - Fax:253-627-5411
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW00000284176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife