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Organization

BLOSSOM MIDWIFERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOANNA JUDITH JECH CPM, LDM (LICENSED MIDWIFE)
(503) 522-4545
Entity
Organization

Contact information

Practice address
4303 SE FIELDCREST DR, MILWAUKIE, OR 97222-5077
(503) 522-4545
(503) 405-8286
Mailing address
4303 SE FIELDCREST DR, MILWAUKIE, OR 97222-5077
(503) 522-4545
(503) 405-8286

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
DEM-LD-10121585
OR
367A00000X
Advanced Practice Midwife
201050147NP
OR

Other

Enumeration date
06/11/2012
Last updated
06/11/2012
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