Provider Demographics
NPI:1245999655
Name:WAPATO CREEK HEALTH AND WELLNESS, INC.
Entity type:Organization
Organization Name:WAPATO CREEK HEALTH AND WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ARNP
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PAPOFF-WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:253-533-5768
Mailing Address - Street 1:3203 WILTON LN E
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-2315
Mailing Address - Country:US
Mailing Address - Phone:253-533-5768
Mailing Address - Fax:866-638-7530
Practice Address - Street 1:3203 WILTON LN E
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-2315
Practice Address - Country:US
Practice Address - Phone:253-533-5768
Practice Address - Fax:866-638-7530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty