Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW60517579 | WA |
NPI | 1174026108 |
---|---|
Provider Name | Kaja Powers |
First Address | Redmond, WA 98053-2712 |
Second Address | Kirkland, WA 98034-2953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2018 |
Last Update Date | 28/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2107918 | (05) | WA |