Provider Demographics
NPI:1801555834
Name:JENKINS, EMILIE LAFORCE (LM)
Entity type:Individual
Prefix:
First Name:EMILIE
Middle Name:LAFORCE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 LINDBERGH AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1516
Mailing Address - Country:US
Mailing Address - Phone:360-594-2187
Mailing Address - Fax:
Practice Address - Street 1:200 3RD ST
Practice Address - Street 2:
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-1411
Practice Address - Country:US
Practice Address - Phone:360-510-0188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61117463176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife