Provider Demographics
NPI:1760631469
Name:WILMHOFF, JOSEPH (ARNP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:WILMHOFF
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 EASTLAKE AVE E STE A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-7127
Mailing Address - Country:US
Mailing Address - Phone:206-861-8200
Mailing Address - Fax:206-324-1178
Practice Address - Street 1:3213 EASTLAKE AVE E STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-7127
Practice Address - Country:US
Practice Address - Phone:206-861-8200
Practice Address - Fax:206-324-1178
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007729208100000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1760631469OtherMONTANA MEDICAID
WA0300238OtherLABOR AND INDUSTRY
WA1760631469Medicaid
WA8926231Medicare PIN
WA1760631469Medicaid