Provider Demographics
NPI:1902438831
Name:VALLEJO, CATHERINE MICHELLE (LABOR DOULA)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MICHELLE
Last Name:VALLEJO
Suffix:
Gender:F
Credentials:LABOR DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1482
Mailing Address - Street 2:
Mailing Address - City:WALDPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97394-1482
Mailing Address - Country:US
Mailing Address - Phone:503-957-8921
Mailing Address - Fax:
Practice Address - Street 1:1060 SW TARA LN
Practice Address - Street 2:
Practice Address - City:WALDPORT
Practice Address - State:OR
Practice Address - Zip Code:97394-9075
Practice Address - Country:US
Practice Address - Phone:503-957-8921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-09
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula