Provider Demographics
NPI:1841921277
Name:WOLF, MICHELLE PATRICE (ARNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:PATRICE
Last Name:WOLF
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:PATRICE
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1460 JOE BARKER RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:WA
Mailing Address - Zip Code:99348-8610
Mailing Address - Country:US
Mailing Address - Phone:509-876-1254
Mailing Address - Fax:
Practice Address - Street 1:2202 S CEDAR ST STE 330
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2318
Practice Address - Country:US
Practice Address - Phone:253-272-5127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10004816363LF0000X
WAAP61321097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily