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General NPI Number Information
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NPI Number | 1861629776
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Entity Type | Individual
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Provider Name | LAURA WULFF MD
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Gender | Female
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 123 BJUNE DR SE # WE
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City | BAINBRIDGE IS
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State | WA
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Zip | 98110-2459
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Country | US
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Telephone | 206-842-3222
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Fax |
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Provider Business Mailing Address
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Address Line | 1947 CLARET LOOP NW
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City | POULSBO
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State | WA
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Zip | 98370-8381
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Country | US
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Telephone | 605-310-0824
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.60400910
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License Number State | WA
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