Provider Demographics
NPI:1669263851
Name:ANACORTES LACTATION AND WELLNESS LLC
Entity type:Organization
Organization Name:ANACORTES LACTATION AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IBCLC/ FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, IBCLC
Authorized Official - Phone:360-230-8350
Mailing Address - Street 1:1415 COMMERCIAL AVE # 238
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2232
Mailing Address - Country:US
Mailing Address - Phone:360-230-8350
Mailing Address - Fax:
Practice Address - Street 1:11080 HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-4356
Practice Address - Country:US
Practice Address - Phone:360-230-8350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No253Z00000XAgenciesIn Home Supportive Care