Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OP60949791 | WA |
N | 111NI0900X | Internist | OP60949791 | WA |
N | 207R00000X | Internist | PG188401 | OR |
N | 111NI0900X | Internist | PG188401 | OR |
N | 207R00000X | Internist | R10401 | IA |
N | 111NI0900X | Internist | R10401 | IA |
Y | 207RG0300X | Geriatric Medicine | OP60949791 | WA |
N | 207RG0300X | Geriatric Medicine | PG188401 | OR |
NPI | 1134527468 |
---|---|
Provider Name | Dr. Cydney Leigh Wolf |
First Address | Vancouver, WA 98664-4896 |
Second Address | Vancouver, WA 98664-1913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2014 |
Last Update Date | 23/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2105836 | (05) | WA |