Selina Petschek, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

AP61553840 Issued in WA

Practice address

22725 44TH Ave W Ste 101
Mountlake Terrace, WA 98043-4500

Phone

(206) 371-0945

Fax

(425) 420-2941

NPI assigned

Feb 7, 2024

Last updated

Sep 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sprout Birth Center & Natural Health, PLLC

  dba Sprout Birth Center

  • Naturopath
  • Mountlake Terrace, WA
  • NPI 1104200823
  NPD (past)
• Sprout Birth Center & Natural Health, PLLC

  dba Sprout Birth Center

  • Birthing Clinic/Center
  • Mountlake Terrace, WA
  • NPI 1881077584
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1265296685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22725 44TH AVE W STE 101",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980434500",
            "telephone_number": "206-371-0945",
            "fax_number": "425-420-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22725 44TH AVE W STE 101",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980434500",
            "telephone_number": "206-371-0945",
            "fax_number": "425-420-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETSCHEK",
        "first_name": "SELINA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61577055",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP61553840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tameka Parker
• David R Penner, PH.D.
• Katrina Perez Smith
• Christopher J Peterson, PHD, MA, LMHC-A
• Kimberly Peterson, LMHC
• Nhat Pham, DDS
• Kevin R Piasecki, MSPT, OCS
• Mary Rose Toledo Picardal, MSW, LICSW
• Andrea Pierce
• Pinpoint Behavioral Services

• Advanced Practice Midwife in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Advanced Practice Midwife in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.