| Tanya Wilke Family Medicine | |
|
1427 Jefferson Ave Suite 202 Enumclaw WA 98022-3649 | |
| (360) 825-2849 | |
| (360) 825-5381 |
| Full Name | Tanya Wilke Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 1427 Jefferson Ave, Enumclaw, Washington |
| Authorized Official Name and Position | Tanya Wilke (PHYSICIAN) |
| Authorized Official Contact | 3608252849 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanya Wilke Family Medicine 1427 Jefferson Ave Suite 202 Enumclaw WA 98022-3649 Ph: (360) 825-2849 | Tanya Wilke Family Medicine 1427 Jefferson Ave Suite 202 Enumclaw WA 98022-3649 Ph: (360) 825-2849 |
| NPI Number | 1598155129 |
|---|---|
| Provider Enumeration Date | 02/04/2015 |
| Last Update Date | 04/30/2015 |
| Medicare PECOS PAC ID | 4587983226 |
|---|---|
| Medicare Enrollment ID | O20150501000515 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598155129 | NPI | - | NPPES |
| 0251251 | Other | WA | STATE L&I |
| 0274400 | Other | WA | STATE L&I |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD60090609 (Washington) | Primary |
| Provider Name | Tanya M Wilke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235339359 PECOS PAC ID: 8022162536 Enrollment ID: I20090818000804 |
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