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Individual

GREGORY LEE WOLFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN/BSN, RN

Contact information

Practice address
9720 S TACOMA WAY, LAKEWOOD, WA 98499-4456
(253) 503-3666
(253) 503-1633
Mailing address
2112 DOGWOOD ST NE, TACOMA, WA 98422-1336
(253) 332-4848

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
60280098
WA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
60280098
WA
163WC0400X
Case Management Registered Nurse
60280098
WA
163WC1500X
Community Health Registered Nurse
Primary
60280098
WA
163WP0808X
Psychiatric/Mental Health Registered Nurse
60280098
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60280098
RN LICENSE
WA
Enumeration date
07/16/2018
Last updated
07/16/2018
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