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NPI Code Detail

MEDICARE: CATHERINE B WILKE M.D.

MEDICARE: CATHERINE B WILKE M.D.
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
1207Q00000XFamily Medicine Physician47947-020WI
2207Q00000XFamily Medicine PhysicianMD60262025WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336137868
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE B WILKE M.D.
Provider Business Mailing Address
First Line : 1019 PACIFIC AVE STE 300
Second Line : ATTN: HR
City : TACOMA
State : WA
Zip : 98402-4488
Country : US
Telephone Number : 253-722-1540
Fax Number :
Provider Business Practice Location Address
First Line : 17500 SE 392ND ST
Second Line :
City : AUBURN
State : WA
Zip : 98092-9705
Country : US
Telephone Number : 253-939-6648
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2005
Last Update Date : 02/26/2020

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Directions to “ CATHERINE B WILKE M.D.” Practice Location

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