Provider Demographics
NPI:1194848473
Name:WOLF, MARGARET ANN (PA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:WOLF
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 NORTH WHITMAN
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-1547
Mailing Address - Country:US
Mailing Address - Phone:253-759-3065
Mailing Address - Fax:253-759-3075
Practice Address - Street 1:3333 N WHITMAN ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-1547
Practice Address - Country:US
Practice Address - Phone:253-759-3065
Practice Address - Fax:253-759-3075
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA00050363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical