Mandala Midwifery LLC

Primary specialty

MidwifeTaxonomy code 176B00000X

Legal business name

MANDALA MIDWIFERY LLC

Practice address

63030 Cole Rd
Bend, OR 97701-9564

Phone

(541) 647-1788

Fax

(541) 205-4885

NPI assigned

Aug 12, 2016

Organization subpart

No

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

Authorized official

Name

Dana Marie Johnson, CPM, LDM

Title

Owner

Phone

(541) 647-1788

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470960000000",
    "number": "1831643337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63030 COLE RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019564",
            "telephone_number": "541-647-1788",
            "fax_number": "541-205-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63030 COLE RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019564",
            "telephone_number": "541-647-1788",
            "fax_number": "541-205-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDALA MIDWIFERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-647-1788",
        "authorized_official_credential": "CPM, LDM"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Patrick Malone, LCSW
• Nancy Maloney, M.D.
• Jennifer Lee Malter-Barrows, M.A.
• Lacie Kay Malvaney, LMT
• Marisa Malzone, CNS
• Kellen Franklyn Mandehr, DO
• Kris Annette Mandel
• Mary Manfredi, MD
• Amy Manion, LMFT
• Jennifer Mankin, RN

• Midwife in Bend, OR
• Providers in Bend, OR by specialty
• Midwife in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.