Provider Demographics
NPI:1679162416
Name:STOLP, CATHERINE ELISABETH (LM, MSC)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ELISABETH
Last Name:STOLP
Suffix:
Gender:F
Credentials:LM, MSC
Other - Prefix:
Other - First Name:INEKE
Other - Middle Name:
Other - Last Name:STOLP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LM, MSC
Mailing Address - Street 1:3330 BICKFORD AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-9289
Mailing Address - Country:US
Mailing Address - Phone:360-453-7872
Mailing Address - Fax:360-525-1025
Practice Address - Street 1:16621 W SNOQUALMIE RIVER RD NE
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-9202
Practice Address - Country:US
Practice Address - Phone:970-481-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW60993420176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMW60993420OtherWA STATE MIDWIFERY LICENSE NUMBER