Provider Demographics
NPI:1447692413
Name:PIXIE, EMILY (CD(DONA), LCCE)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:PIXIE
Suffix:
Gender:F
Credentials:CD(DONA), LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 UNION AVE SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1851
Mailing Address - Country:US
Mailing Address - Phone:360-790-6318
Mailing Address - Fax:
Practice Address - Street 1:1959 UNION AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1851
Practice Address - Country:US
Practice Address - Phone:360-790-6318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602687975374J00000X
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No374J00000XNursing Service Related ProvidersDoula