Provider Demographics
NPI:1053046318
Name:BOWER, MICAH DIELLE READ
Entity type:Individual
Prefix:
First Name:MICAH
Middle Name:DIELLE READ
Last Name:BOWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 RAINIER CIR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4157
Mailing Address - Country:US
Mailing Address - Phone:303-715-8628
Mailing Address - Fax:
Practice Address - Street 1:1113 RAINIER CIR
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-4157
Practice Address - Country:US
Practice Address - Phone:303-715-8628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula