Provider Demographics
NPI:1649302555
Name:FLATHEAD FAMILY PLANNING
Entity type:Organization
Organization Name:FLATHEAD FAMILY PLANNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-751-8155
Mailing Address - Street 1:1035 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-5607
Mailing Address - Country:US
Mailing Address - Phone:406-751-8150
Mailing Address - Fax:406-751-8151
Practice Address - Street 1:1035 1ST AVE W
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5607
Practice Address - Country:US
Practice Address - Phone:406-751-8150
Practice Address - Fax:406-751-8151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12999363LW0102X
MTML1386348363LW0102X
MT15471367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT80382Medicare ID - Type Unspecified