Individual provider Active NPI

Catherine B Wilke, M.D.

  • Family Medicine Physician
  • Auburn, WA
National Provider Identifier
1336137868
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60262025 Issued in WA
Practice address
17500 SE 392ND St
Auburn, WA 98092-9705
Phone
(253) 939-6648
NPI assigned
Oct 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47947-020 WI
Family Medicine Physician 207Q00000X MD60262025 WA Primary

Addresses

Primary practice location

17500 SE 392ND St
Auburn, WA 98092-9705

Mailing address

1019 Pacific Ave Ste 300
Attn: HR
Tacoma, WA 98402-4488
Phone (253) 722-1540

Other practice location 1

10510 Gravelly Lake Dr SW
Lakewood, WA 98499-5036
Phone (253) 589-7030

Other identifiers 2

IdentifierTypeStateIssuer
34663700MedicaidWI
2016063MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120312000470 WA Practitioner - Family Practice 6103853999 Reassigns benefits to 1 organization
I20180125001568 TX Practitioner - Family Practice 6103853999 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47947-020WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jul 23, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
Muckleshoot Indian Tribe CurrentSince Jan 2, 2018 Accepting new patients
Multicare Health System CurrentSince Jul 23, 2021 Accepting new patients
St. Joseph'S Health Services, Inc. Past Accepting new patients
Mercy Health Services-Iowa Corp Past Accepting new patients
Mercy Medical Center North Iowa Past Accepting new patients

Locations

17500 SE 392nd St
Auburn, WA 98092
Phone (253) 939-6648

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1336137868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 PACIFIC AVE STE 300",
            "address_2": "ATTN: HR",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024488",
            "telephone_number": "253-722-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 SE 392ND ST",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980929705",
            "telephone_number": "253-939-6648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10510 Gravelly Lake Dr SW",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984995036",
            "country_code": "US",
            "telephone_number": "253-589-7030",
            "fax_number": "253-589-7033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKE",
        "first_name": "CATHERINE",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "47947-020",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60262025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34663700",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016063",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.