CAMERON SETH WOLTERSTORFF (NPI# 1447582861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447582861 |
| Entity Type | Individual |
| Full Name | CAMERON SETH WOLTERSTORFF |
| Credential | M.D. |
| Practice Address |
9040 Jackson Ave Madigan Army Medical Center Tacoma WA 98431-1000 |
| Mailing Address |
9040 Jackson Ave Tacoma WA 98431-1000 |
| Practice Telephone | 2539682997 |
| Mailing Telephone | 2539682997 |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2019-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641694 | Muhammad Ayub | Family Medicine | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2005-06-30 |
| 1699399659 | Haywood Maurice Mcrae | Social Worker | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2020-06-04 |
| 1710490677 | Layne Jensen | Registered Nurse | 9040 Jackson Ave Madigan Army Medical Center, Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-11-14 |
| 1437679636 | Michael John Zylstra | General Practice | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-5001 | 2017-06-20 |
| 1033666581 | Diana Monzon | Registered Nurse | 9040 Jackson Ave Madigan Army Medical Center, Attn: Mchj-clq-c, Tacoma, WA 98413-1100 | 2016-09-01 |
| 1639541717 | Justin Schafer | Physician Assistant | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2015-10-28 |
| 1164768008 | Kelly Avant | Physical Therapist | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2012-12-21 |
| 1013270180 | Nichole Lynn Mogharreban | Psychologist | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2012-06-22 |
| 1891058145 | Kristopher M Peters | Dermatology | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-4613 | 2012-06-21 |
| 1992066765 | Matthew Steven Reece | Anesthesiology | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-5001 | 2012-06-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780292466 | Katharine Ishida | Student in an Organized Health Care Education/Training Program | 1933 Dock St Unit 428, Tacoma, WA 98402-3273 | 2020-07-17 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1326675984 | Kyle Wilburn | Student in an Organized Health Care Education/Training Program | 1202 Martin Luther King Jr Way Ste 310, Tacoma, WA 98405-3926 | 2020-03-24 |
| 1629601265 | Andrew Tran Do | Student in an Organized Health Care Education/Training Program | 3401 49th St Ne, Tacoma, WA 98422-4617 | 2020-02-21 |
| 1033742986 | Molly Elisabeth Chandler | Student in an Organized Health Care Education/Training Program | 9409 Jackson Ave, Tacoma, WA 98431-0001 | 2020-02-19 |
| 1801434469 | Zachary Smith | Student in an Organized Health Care Education/Training Program | 1001 N Yakima Ave Apt 107, Tacoma, WA 98403-2536 | 2019-12-13 |
| 1912544941 | Laura Weeks | Student in an Organized Health Care Education/Training Program | 1010 122nd St S, Tacoma, WA 98447-0001 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1154967339 | Angela Kennedy | Student in an Organized Health Care Education/Training Program | 12180 Park Ave S Pacific Lutheran University, Tacoma, WA 98447-0001 | 2019-11-21 |
| 1174171771 | Natali Barnes | Student in an Organized Health Care Education/Training Program | Business Mailing Address 9040 Jackson Ave, Tacoma, WA 98431-5650 | 2019-08-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.