Organization
TANYA WILKE FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANYA WILKE MD (PHYSICIAN)
(360) 825-2849
Entity
Organization
Contact information
Practice address
1427 JEFFERSON AVE, SUITE 202, ENUMCLAW, WA 98022-3649
(360) 825-2849
(360) 825-5381
Mailing address
1427 JEFFERSON AVE, SUITE 202, ENUMCLAW, WA 98022-3649
(360) 825-2849
(360) 825-5381
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD60090609
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0251251
STATE L&I
WA
01
—
0274400
STATE L&I
WA
Enumeration date
02/04/2015
Last updated
04/30/2015
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