Provider Demographics
NPI:1588994412
Name:WOLF, ANIQUE (BSC(PHARM))
Entity type:Individual
Prefix:MRS
First Name:ANIQUE
Middle Name:
Last Name:WOLF
Suffix:
Gender:F
Credentials:BSC(PHARM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4468 STONE WAY N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-7587
Mailing Address - Country:US
Mailing Address - Phone:206-547-1226
Mailing Address - Fax:206-547-5032
Practice Address - Street 1:4468 STONE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7587
Practice Address - Country:US
Practice Address - Phone:206-547-1226
Practice Address - Fax:206-547-5032
Is Sole Proprietor?:No
Enumeration Date:2009-12-26
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00045002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist