Bolz, Justina M
Bolz, Justina M is an individual health care provider with primary practice located at 820 N Chelan Ave , Wenatchee WA 98801-2028. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Bolz, Justina M can be contacted via phone (509) 663-8711.Contact Information
Primary practice address
820 N Chelan Ave
Wenatchee WA 98801-2028
Phone: (509) 663-8711
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00042181 | Washington |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | MD00042181 | Washington |
Profile Details
| NPI number | 1760418339 |
|---|---|
| LBN Legal business name | Bolz, Justina M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2006 |
| Last updated | Jul 13th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760418339 | NPPES |
| Washington | Other | P01428115 | RR PTAN |
| Washington | MEDICAID | 1760418339 | RR PTAN |
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