Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW00000075 | WA |
NPI | 1073548475 |
---|---|
Provider Name | Kathy Luch |
First Address | Port Townsend, WA 98368-0130 |
Second Address | Port Townsend, WA 98368-6005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9601360 | (05) | WA |