MEDICARE: MR. ANDREW H WOLFE L.M.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA00003791	WA

General Provider Information

NPI Number	:	1780753145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW H WOLFE L.M.P.

Provider Business Mailing Address
First Line	:	16410 SMOKEY POINT BLVD
Second Line	:	SUITE 303
City	:	ARLINGTON
State	:	WA
Zip	:	98223-8415
Country	:	US
Telephone Number	:	360-653-4657
Fax Number	:	360-653-0143

Provider Business Practice Location Address
First Line	:	16410 SMOKEY POINT BLVD
Second Line	:	SUITE 303
City	:	ARLINGTON
State	:	WA
Zip	:	98223-8415
Country	:	US
Telephone Number	:	360-653-4657
Fax Number	:	360-653-0143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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