Provider Demographics
NPI:1437169885
Name:WOLKENSTEIN, BONNIE HELANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:HELANE
Last Name:WOLKENSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3429 FREMONT PL N STE 311
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8661
Mailing Address - Country:US
Mailing Address - Phone:206-914-1444
Mailing Address - Fax:806-214-1444
Practice Address - Street 1:3429 FREMONT PL N STE 311
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8661
Practice Address - Country:US
Practice Address - Phone:206-914-1444
Practice Address - Fax:806-214-1444
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002451103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AB13884Medicare ID - Type Unspecified
WAG8867659Medicare PIN
R15564Medicare UPIN