Provider Demographics
NPI:1578898656
Name:WOHLGEMUTH, ANNA C (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:C
Last Name:WOHLGEMUTH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 SE BARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3266
Mailing Address - Country:US
Mailing Address - Phone:360-675-2235
Mailing Address - Fax:360-679-2150
Practice Address - Street 1:555 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-2750
Practice Address - Country:US
Practice Address - Phone:716-664-7601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60293164152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty