Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW60939324 | WA |
NPI | 1093371296 |
---|---|
Provider Name | Lisa Nicole Drewry |
First Address | Seattle, WA 98115-3029 |
Second Address | Seattle, WA 98115-3029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2019 |
Last Update Date | 13/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MW60939324 | MIDWIFE LICENSE (01) | WA |