Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175M00000X | Lay Midwife | MW61008987 | WA |
Y | 176B00000X | Midwife | MW61008987 | WA |
NPI | 1154964187 |
---|---|
Provider Name | Mrs. Ellena Karpenko |
First Address | Marysville, WA 98270-4663 |
Second Address | Lake Stevens, WA 98258-8878 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2019 |
Last Update Date | 22/10/2019 |