WATERFALLS LONGEVITY CENTER PLLC (NPI# 1154863157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154863157 |
| Entity Type | Organization |
| Organization Name | WATERFALLS LONGEVITY CENTER PLLC |
| Practice Address |
9144 Burnett Rd Se Ste B-3 Yelm WA 98597-8488 |
| Practice Telephone | 3604002111 |
| Practice Fax Number | 3604002112 |
| Mailing Telephone | 3604002111 |
| Mailing Fax Number | 3604002112 |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2016-11-23 |
| Authorized Official Name | DR. MILAGROS AROCHO (OWNER/DOCTOR) |
| Authorized Official Telephone | 3604002111 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
00046050 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | PHYSICIAN LICENSE | MD00046050 | 01 |
| Street Address |
9144 BURNETT RD SE STE B-3 |
| City | YELM |
| State | WA |
| Zip Code | 98597-8488 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396754313 | Crystal Martin | Chiropractor | 9144 Burnett Rd Se, Suite B1 and B2, Yelm, WA 98597-8488 | 2006-08-07 |
| 1215142203 | Suzanne Fairbrother | Psychologist | 9144 Burnett Rd Se, Ste B4, Yelm, WA 98597-8488 | 2007-05-11 |
| 1649499310 | Ann E Fain | Massage Therapist | 9144 Burnett Rd Se, Yelm, WA 98597-8488 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538652888 | Michael Nathan Steim | Dentist | 504 Yelm Avenue West, Yelm, WA 98597 | 2018-06-12 |
| 1457854549 | Ursula Schanne | Massage Therapist | 10501 Creek St Se Ste 7, Yelm, WA 98597 | 2018-03-14 |
| 1215449079 | Kaylee Jean Cook | Occupational Therapy Assistant | 107 1st Street Ne, Yelm, WA 98597 | 2017-11-01 |
| 1740705615 | Heather Anne Ervine | Physical Therapy Assistant | 14809 89th Ave Se, Yelm, WA 98597 | 2017-08-11 |
| 1679014559 | Beverly Dunford | Massage Therapist | 404 1st St S Ste. H, Yelm, WA 98597 | 2017-03-13 |
| 1740735158 | Amanda Kroboth | Speech-Language Pathologist | 16535 110th Ave Se, Yelm, WA 98597 | 2016-08-16 |
| 1134587090 | Lopaka Thanh Son Los Banos | Massage Therapist | 35617 Wa-507, Yelm, WA 98597 | 2016-02-08 |
| 1629472816 | Michelle Louise Punzel | Registered Nurse | 202 Stevens Ave Nw, Yelm, WA 98597 | 2014-10-16 |
| 1386074581 | Bobbi J Ashley | Counselor | 202 Cullens Rd, Yelm, WA 98597 | 2013-11-25 |
| 1295008100 | Trina Baggett | Doula | 21618 N Clearlake Blvd Se, Yelm, WA 98597 | 2012-02-23 |
| Find all providers in zip 98597 | ||||
| Taxonomy Code | 207VX0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Obstetrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215498779 | Community Pregnancy Center of Camas/washougal | Obstetrics & Gynecology | 2926 E St, Washougal, WA 98671-2021 | 2019-03-27 |
| 1720422512 | Options360 Women's Clinic | Obstetrics & Gynecology | 221 Ne 104th Ave Ste 209, Vancouver, WA 98664-4505 | 2013-04-23 |
| 1174673214 | Theresa Agnes Burdick | Obstetrics & Gynecology | 801 Broadway Ste 707, Seattle, WA 98122-4328 | 2007-01-11 |
| 1801988878 | Daniel E Bahnmiller | Obstetrics & Gynecology | 138 Keene Rd, Richland, WA 99352-8683 | 2006-09-28 |
| 1326154881 | James Vincent Brasch | Obstetrics & Gynecology | 212 E Central Ave Ste 340, Spokane, WA 99208-6289 | 2006-08-21 |
| 1154313674 | Candace C Green | Obstetrics & Gynecology | 2630 N Columbia Center Blvd, Suite B, Richland, WA 99352-4853 | 2005-08-19 |
| 1093350977 | Roseline Buyeka | Obstetrics & Gynecology | 3815 S Othello St, Seattle, WA 98118-3510 | 2019-11-14 |
| 1306295605 | Lorraine Robertsonmd | Obstetrics & Gynecology | 12520 Sunrise Dr Ne, Bainbridge Island, WA 98110-4307 | 2016-06-07 |
| 1710394572 | Caitlin Schuh | Obstetrics & Gynecology | 9040 Jackson Ave, Tacoma, WA 98431-7324 | 2014-07-14 |
| 1790120145 | Malcolm William, George Hardy | Obstetrics & Gynecology | 320 W Willow St, Walla Walla, WA 99362-2922 | 2013-04-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.