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Organization

ROGUE BIRTH CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLA ANNE WOODARD ERVIN CPM, LDM (OWNER & DIRECTOR)
(541) 210-0134
Entity
Organization

Contact information

Practice address
1453 REDWOOD CIR, GRANTS PASS, OR 97527-5523
(541) 210-0134
Mailing address
1453 REDWOOD CIR, GRANTS PASS, OR 97527-5523
(541) 210-0134

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
261QB0400X
Birthing Clinic/Center

Other

Enumeration date
04/20/2016
Last updated
05/31/2016
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