Provider Demographics
NPI:1306082854
Name:WOLPAW, DIANA L (RN, PHN, MPH)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:L
Last Name:WOLPAW
Suffix:
Gender:F
Credentials:RN, PHN, MPH
Other - Prefix:MISS
Other - First Name:DIANA
Other - Middle Name:L
Other - Last Name:PLUMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3020 RUCKER AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3900
Mailing Address - Country:US
Mailing Address - Phone:425-339-8658
Mailing Address - Fax:425-339-5255
Practice Address - Street 1:3020 RUCKER AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201
Practice Address - Country:US
Practice Address - Phone:425-339-8658
Practice Address - Fax:425-339-5255
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00176077163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health