Provider Demographics
NPI:1457368284
Name:WISHNIE WOLFE, ELANA J (ARNP)
Entity Type:Individual
Prefix:
First Name:ELANA
Middle Name:J
Last Name:WISHNIE WOLFE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ELANA
Other - Middle Name:JOAN
Other - Last Name:WISHNIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3023 NE 103RD ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-7716
Mailing Address - Country:US
Mailing Address - Phone:206-352-3964
Mailing Address - Fax:
Practice Address - Street 1:CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER
Practice Address - Street 2:4800 SAND POINT WAY NE, W-7729
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-2039
Practice Address - Fax:206-987-3925
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004279363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP498WAMedicaid
ID806597900Medicaid
WA9627639Medicaid
MT4301024Medicaid
AB37809Medicare ID - Type Unspecified
P29544Medicare UPIN