Provider Demographics
NPI:1871052316
Name:MILHOLLAND, RACHEL MEREDITH (LM, CPM)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MEREDITH
Last Name:MILHOLLAND
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 1:1829 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-7912
Mailing Address - Country:US
Mailing Address - Phone:360-316-9100
Mailing Address - Fax:
Practice Address - Street 1:1118 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-6526
Practice Address - Country:US
Practice Address - Phone:360-316-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
18120014176B00000X
WAMW60926121176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife