Healthcare Provider Details

I. General information

NPI: 1528313335
Provider Name (Legal Business Name): LINDA LOUISE WOLFE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 SE COURT AVE
PENDLETON OR
97801-3216
US

IV. Provider business mailing address

43740 HACKAMORE TRL
PENDLETON OR
97801-9317
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-1348
  • Fax:
Mailing address:
  • Phone: 541-966-9335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number098000438RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: