Provider Demographics
NPI:1235826629
Name:YOUNG, HANNAH ROSE (LM, CPM)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ROSE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10278 NELS NELSON RD NW
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-7002
Mailing Address - Country:US
Mailing Address - Phone:971-998-7574
Mailing Address - Fax:
Practice Address - Street 1:11505 BURNHAM DR STE 104A
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-9173
Practice Address - Country:US
Practice Address - Phone:971-998-7574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
176B00000X
WAMW61466967176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife