Organization
LAKESIDE BIRTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY SPENCER LM (OWNER)
(253) 862-6533
Entity
Organization
Contact information
Practice address
2722 214 AVE EAST, LAKE TAPPS, WA 98391-6245
(253) 862-6533
(253) 862-1840
Mailing address
2722 214 AVE EAST, LAKE TAPPS, WA 98391-6245
(253) 862-6533
(253) 862-1840
Taxonomy
Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7060452
—
WA
Enumeration date
12/06/2006
Last updated
08/22/2020
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