Healthcare Provider Details

I. General information

NPI: 1750209235
Provider Name (Legal Business Name): KATIEANN WOHLFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 N 200TH ST
SHORELINE WA
98133-3006
US

IV. Provider business mailing address

402 N 200TH ST
SHORELINE WA
98133-3006
US

V. Phone/Fax

Practice location:
  • Phone: 402-316-2718
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberCWN8307
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: