Individual provider Active NPI

Karen M Wildman, MD

  • Family Medicine Physician
  • Spokane, WA
National Provider Identifier
1861439770
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60026899 Issued in WA
Practice address
624 E Front Ave
Spokane, WA 99202-2139
Phone
(509) 626-9900
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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 5169A WY
Family Medicine Physician 207Q00000X MD60026899 WA Primary

Addresses

Primary practice location

624 E Front Ave
Spokane, WA 99202-2139

Mailing address

PO Box 31001-4114
Pasadena, CA 91110-0001
Phone (866) 747-2455

Other identifiers 1

IdentifierTypeStateIssuer
1054554-00MedicaidWY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwildman206591@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090722000087 WA Practitioner - Family Practice 8729155445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 E Columbia Ave
Colville, WA 99114-3354
Phone (509) 684-3701

624 E Front Ave
Spokane, WA 99202-2139

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60026899WAMDFamily Medicine Physician
5169AWYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Family Medicine CurrentSince Apr 1, 2012 Accepting new patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince May 14, 2009 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince May 14, 2009 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Inland Empire Hospital Services Association Family Medicine Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

820 S McClellan St
Ste LL20
Spokane, WA 99204
Phone (509) 353-3973

101 W 8th Ave
Ste 1300
Spokane, WA 99204
Phone (509) 474-2444

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

104 W 5th Ave
Ste 200W
Spokane, WA 99204
Phone (509) 624-2313

101 W 8th Ave
Fl 3
Spokane, WA 99204
Phone (509) 474-2277

624 E Front Ave
Spokane, WA 99202
Phone (509) 626-9900

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: kwildman206591@wm.providencedirect.org

Organizations & group practices 6

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1861439770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-4114",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100001",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E FRONT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022139",
            "telephone_number": "509-626-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDMAN",
        "first_name": "KAREN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "5169A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60026899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1054554-00",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwildman206591@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "101 W 8th Ave Ste 1300",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.