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General NPI Number Information
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NPI Number | 1447258801
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Entity Type | Individual
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Provider Name | PETER WOLFF M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 875 WESLEY ST STE 230
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City | ARLINGTON
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State | WA
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Zip | 98223-1668
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Country | US
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Telephone | 360-435-6097
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Fax | 360-435-1871
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Provider Business Mailing Address
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Address Line | 1400 E KINCAID ST ATTN: CREDENTIALING
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City | MOUNT VERNON
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State | WA
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Zip | 98274-4127
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Country | US
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Telephone | 360-428-2500
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Fax | 360-428-6485
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD00025578
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD00022578
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License Number State | WA
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