Provider Demographics
NPI:1639560022
Name:SEATTLE BIRTH CENTER
Entity type:Organization
Organization Name:SEATTLE BIRTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEATON
Authorized Official - Suffix:
Authorized Official - Credentials:LM CPM
Authorized Official - Phone:206-659-5645
Mailing Address - Street 1:2705 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4738
Mailing Address - Country:US
Mailing Address - Phone:206-659-5645
Mailing Address - Fax:206-641-7186
Practice Address - Street 1:2705 E MADISON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4738
Practice Address - Country:US
Practice Address - Phone:206-659-5645
Practice Address - Fax:206-641-7186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACBC010261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1841543493Medicaid