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General NPI Number Information
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NPI Number | 1366869893
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Entity Type | Individual
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Provider Name | STEPHEN J WOLD II DPM
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Gender | Male
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Dates
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Enumeration Date | 03/21/2014
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 16701 NE MCGILLIVRAY BLVD STE 220
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City | VANCOUVER
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State | WA
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Zip | 98683
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Country | US
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Telephone | 360-834-3707
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Fax | 360-834-3569
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Provider Business Mailing Address
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Address Line | 16701 NE MCGILLIVRAY BLVD STE 220
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City | VANCOUVER
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State | WA
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Zip | 98683
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Country | US
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Telephone | 360-834-3707
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Fax | 360-834-3569
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E5353
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO60830095
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO60830095
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License Number State | WA
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