MEDICARE: EMILY JANE WINGFIELD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	MD60100624	WA

General Provider Information

NPI Number	:	1043321524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY JANE WINGFIELD MD

Provider Business Mailing Address
First Line	:	3832 CALIFORNIA AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-3704
Country	:	US
Telephone Number	:	206-588-5215
Fax Number	:	206-785-8078

Provider Business Practice Location Address
First Line	:	3832 CALIFORNIA AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-3704
Country	:	US
Telephone Number	:	206-588-5215
Fax Number	:	206-785-8078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	09/17/2025

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