Tanya Marie Wilke, MD
Individual provider Active NPI Family Medicine Physician · Enumclaw, WA
NPI 1235339359 · NPPES record last updated Jan 17, 2015
Key facts
- NPI
- 1235339359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD60090609 (WA)
- Practice address
- 1427 Jefferson Ave
Suite 202
Enumclaw, WA 98022-3649 - Phone
- (360) 825-2849
- Fax
- (360) 825-5381
- NPI assigned
- Jul 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Louisiana State University School of Medicine in New Orleans, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1427 Jefferson Ave
Suite 102
Enumclaw, WA 98022-3649
Phone (360) 825-2849
Hospital & facility affiliations
- St Elizabeth Hospital
- St Joseph Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090818000804 | WA | Practitioner - Family Practice | 8022162536 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ML20008540 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridging Medicine PLLC | Family Medicine | Current | Accepting new patients |
| Tanya Wilke Family Medicine | Current |
Accepting new patients | |
| Enumclaw Internal Medicine and Diagnostics, PS | Past | Accepting new patients | |
| Franciscan Medical Group | Family Medicine | Past | Accepting new patients |
| Enumclaw Regional Hospital Association | Past | Accepting new patients |
Locations
1427 Jefferson Ave
Ste 102
Enumclaw, WA 98022
Phone (360) 802-0803
1455 Battersby Ave
Enumclaw, WA 98022
Phone (253) 552-5615
1427 Jefferson Ave
Ste 202
Enumclaw, WA 98022
Phone (360) 226-3672
Interoperability endpoints
- tanya.wilke.1@17803.direct.athenahealth.com
- https://api.platform.athenahealth.com/10664/brand/1/csg/1/fhir/r4
- tanya.wilke.1@10664.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ML20008540 | WA | |
| Family Medicine Physician | 207Q00000X | MD60090609 | WA | Yes |
Addresses
Primary practice location
1427 Jefferson Ave
Suite 202
Enumclaw, WA 98022-3649
Mailing address
1427 Jefferson Ave
Suite 202
Enumclaw, WA 98022-3649
Phone (360) 825-2849
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0274400 | Other | WA | STATE L&I |
| 0251251 | Other | WA | STATE L&I |
Other providers in Enumclaw, WA
- White River Community Healthcare LLC
- White River MC Healthcare LLC
- Carol M Wick
- Carla J Wilbur
- Teri Wilcox
- Ryan Willis
- Andrew N Willner
- Samantha La Wilson
- Womens Wellness PLLC
- Kristi Nicole Woodward
All providers in Enumclaw, WA · Family Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.