Provider Demographics
NPI:1902275373
Name:MOTHER & CHILD NATURAL MEDICINE
Entity Type:Organization
Organization Name:MOTHER & CHILD NATURAL MEDICINE
Other - Org Name:TOLT RIVER FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:425-333-4600
Mailing Address - Street 1:PO BOX 1184
Mailing Address - Street 2:
Mailing Address - City:CARNATION
Mailing Address - State:WA
Mailing Address - Zip Code:98014-1184
Mailing Address - Country:US
Mailing Address - Phone:425-333-4600
Mailing Address - Fax:
Practice Address - Street 1:4563 TOLT AVE
Practice Address - Street 2:
Practice Address - City:CARNATION
Practice Address - State:WA
Practice Address - Zip Code:98014-1184
Practice Address - Country:US
Practice Address - Phone:425-333-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center