Provider Demographics
NPI:1932830254
Name:BRODERS, NATALIE (DOULA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:BRODERS
Suffix:
Gender:F
Credentials: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 1278
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-1278
Mailing Address - Country:US
Mailing Address - Phone:503-380-0316
Mailing Address - Fax:
Practice Address - Street 1:35068 PITTSBURG RD
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-3401
Practice Address - Country:US
Practice Address - Phone:503-380-0316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula