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Organization
BRIGHT EYES MIDWIFERY AND WILD RIVERS WOMENS HEALTH,LLC
Active
Organization
BRIGHT EYES MIDWIFERY AND WILD RIVERS WOMENS HEALTH,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN WEBER DOUGHERTY (OFFICE MANAGER)
(541) 260-5762
Entity
Organization
Contact information
Practice address
29135 ELLENSBURG AVE, GOLD BEACH, OR 97444-8722
(541) 260-5762
Mailing address
PO BOX 1710, GOLD BEACH, OR 97444-1710
(541) 260-5762
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200950160NP
OR
367A00000X
Advanced Practice Midwife
000031286N5
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172189
—
OR
05
—
500614877
—
OR
Enumeration date
02/27/2014
Last updated
02/27/2014
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