Active NPI
Eric Paul Wolke
- Homemaker
- Albany, OR
National Provider Identifier
1679088454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- 15-2345
- Practice address
- 2225 Pacific Blvd SE Ste 207
Albany, OR 97321-7904 - Phone
- (971) 720-6299
- NPI assigned
- Dec 3, 2017
- Last updated
- Dec 3, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | 15-2345 | OR | Primary |
Addresses
Primary practice location
2225 Pacific Blvd SE Ste 207
Albany, OR 97321-7904
Mailing address
134 11TH St
Jefferson, OR 97352-9353
Phone (503) 409-3801
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-2345 | OR | MD | Homemaker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512259200000",
"number": "1679088454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 11TH ST",
"city": "JEFFERSON",
"state": "OR",
"postal_code": "973529353",
"telephone_number": "503-409-3801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 PACIFIC BLVD SE STE 207",
"city": "ALBANY",
"state": "OR",
"postal_code": "973217904",
"telephone_number": "971-720-6299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLKE",
"first_name": "ERIC",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-03",
"last_updated": "2017-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "OR",
"license": "15-2345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.