Provider Demographics
NPI:1366869893
Name:WOLD, STEPHEN J II (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:WOLD
Suffix:II
Gender:M
Credentials:DPM
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Mailing Address - Street 1:16701 NE MCGILLIVRAY BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683
Mailing Address - Country:US
Mailing Address - Phone:360-834-3707
Mailing Address - Fax:360-834-3569
Practice Address - Street 1:16701 NE MCGILLIVRAY BLVD
Practice Address - Street 2:STE 220
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683
Practice Address - Country:US
Practice Address - Phone:360-834-3707
Practice Address - Fax:360-834-3569
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2021-11-29
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Provider Licenses
StateLicense IDTaxonomies
CAE5353213ES0103X
WAPO60830095213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery