Jennifer Lee Wolbach, CPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

Practice address

317 Wellsian Way
Richland, WA 99352-4116

Phone

(095) 943-8561

Fax

(509) 943-1037

NPI assigned

Nov 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Jennifer Lee Fraley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Yakima Orthotics and Prosthetics P C

  • Prosthetic/Orthotic Supplier
  • Yakima, WA
  • NPI 1245437326
  NPD (past)

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1114479573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 WELLSIAN WAY",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524116",
            "telephone_number": "509-943-8561",
            "fax_number": "509-943-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WELLSIAN WAY",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524116",
            "telephone_number": "095-943-8561",
            "fax_number": "509-943-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLBACH",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114479573",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FRALEY",
            "middle_name": "LEE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pauline Wiltz, DO
• Jilene M Winther, PHARMD
• Kendell Wintle, CBT
• Elizabeth Anne Wise, R.N.
• Brittany Woehle, MS, CCC-SLP
• Wolfert Enterprises, P.S.
• Jared Wolfert, D.O.
• Talia J Wolfgramm
• Womens Mental Health Services and Medication Management LTD, PS
• Gene K Wong, M.D.

• Prosthetist in Richland, WA
• Providers in Richland, WA by specialty
• Prosthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.