Individual provider Active NPI

Tamicka Shaneen Wolfe

  • Case Manager/Care Coordinator
  • Vancouver, WA
National Provider Identifier
1073030904
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
9300 NE Oak View Dr
Vancouver, WA 98662-6157
Phone
(360) 567-2211
Fax
(360) 567-2212
NPI assigned
Aug 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Case Manager/Care Coordinator 171M00000X WA Primary

Addresses

Primary practice location

9300 NE Oak View Dr
Vancouver, WA 98662-6157

Mailing address

9300 NE Oak View Dr
Vancouver, WA 98662-6157
Phone (360) 567-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1073030904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 NE OAK VIEW DR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626157",
            "telephone_number": "360-567-2211",
            "fax_number": "360-567-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 NE OAK VIEW DR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626157",
            "telephone_number": "360-567-2211",
            "fax_number": "360-567-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "TAMICKA",
        "middle_name": "SHANEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.