Healthcare Provider Details

I. General information

NPI: 1992966311
Provider Name (Legal Business Name): MARIKA D WOLFE MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11719 NE 95TH ST STE AD
VANCOUVER WA
98682-2444
US

IV. Provider business mailing address

11719 NE 95TH ST STE AD
VANCOUVER WA
98682-2444
US

V. Phone/Fax

Practice location:
  • Phone: 360-397-8246
  • Fax:
Mailing address:
  • Phone: 360-397-8246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberMD153239
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD153239
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: