Organization
DELLA VITA MIDWIFERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETSY CAMILLE SMITH CNM (CO-OWNER)
(360) 719-2171
Entity
Organization
Contact information
Practice address
11801 NE 65TH ST STE C, VANCOUVER, WA 98662-5527
(360) 719-2171
(360) 719-2172
Mailing address
16107 NE 33RD AVE, RIDGEFIELD, WA 98642-9553
(360) 901-7593
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
AP30004086
WA
367A00000X
Advanced Practice Midwife
AP30007116
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005793
—
WA
05
—
1044459
—
WA
01
—
1245255660
NPI
—
01
—
1497770812
NPI
—
01
—
G8904127
PTAN
—
01
—
G8904128
PTAN
—
Enumeration date
09/06/2013
Last updated
11/14/2017
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