Provider Demographics
NPI:1679457162
Name:MORTENSEN, FIONA (DOULA)
Entity type:Individual
Prefix:
First Name:FIONA
Middle Name:
Last Name:MORTENSEN
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12803 17TH AVE E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445-3546
Mailing Address - Country:US
Mailing Address - Phone:253-366-0663
Mailing Address - Fax:
Practice Address - Street 1:12803 17TH AVE E
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445-3546
Practice Address - Country:US
Practice Address - Phone:253-366-0663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula