Basic Information
| Provider Information | |||||||||
| NPI: | 1013231984 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOLFF | ||||||||
| FirstName: | RUTH | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 875 WESLEY ST | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982231613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604038158 | ||||||||
| FaxNumber: | 3604037098 | ||||||||
| Practice Location | |||||||||
| Address1: | 875 WESLEY ST | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982231613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604038158 | ||||||||
| FaxNumber: | 3604037098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2010 | ||||||||
| LastUpdateDate: | 04/11/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP 30002303 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 312273 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 1046234 | 05 | WA | MEDICAID |