Provider Demographics
NPI:1750369732
Name:WELLS, KAREN VANAUKEN (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:VANAUKEN
Last Name:WELLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13440 NE 148TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-4612
Mailing Address - Country:US
Mailing Address - Phone:425-825-9461
Mailing Address - Fax:
Practice Address - Street 1:12303 NE 130TH LN
Practice Address - Street 2:SUITE 500
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3099
Practice Address - Country:US
Practice Address - Phone:425-899-4455
Practice Address - Fax:425-899-4434
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035279207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8212268Medicaid
WAG56542Medicare UPIN
WA00105989Medicare ID - Type Unspecified