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NPI Code Detail

MEDICARE: MRS. KATERINA STURSOVA-WOLFF M.D.

MEDICARE: MRS. KATERINA STURSOVA-WOLFF 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
1208000000XPediatrics PhysicianMD60451748WA
2208000000XPediatrics Physician216086MA

General Provider Information

NPI Number : 1386620896
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATERINA STURSOVA-WOLFF M.D.
Provider Business Mailing Address
First Line : PO BOX 5127
Second Line :
City : EVERETT
State : WA
Zip : 98206-5127
Country : US
Telephone Number : 425-397-1702
Fax Number : 425-335-5145
Provider Business Practice Location Address
First Line : 8910 VERNON RD
Second Line :
City : LAKE STEVENS
State : WA
Zip : 98258-2400
Country : US
Telephone Number : 425-397-1702
Fax Number : 425-335-5145
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2005
Last Update Date : 01/04/2019

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Directions to “ MRS. KATERINA STURSOVA-WOLFF M.D.” Practice Location

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