Organization
OFF THE GRID MIDWIFERY AND WOMEN'S HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN B JACKSON CNM, ARNP (OWNER, ADMINISTRATOR)
(253) 509-2960
Entity
Organization
Contact information
Practice address
6002 WESTGATE BLVD, SUITES 270 & 274, TACOMA, WA 98406-2570
(253) 509-2960
(253) 292-1045
Mailing address
6002 WESTGATE BLVD, SUITE 120, TACOMA, WA 98406-2570
(253) 509-2960
(253) 292-1045
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
AP30003731
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12013042
CAQH
WA
01
—
1780661694
NPPES
—
05
—
9620246
—
WA
Enumeration date
03/02/2017
Last updated
03/02/2017
Update your record
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