Provider Demographics
NPI:1487764502
Name:SUTTON-WOLF, ANNIKA KAI (MD)
Entity type:Individual
Prefix:
First Name:ANNIKA
Middle Name:KAI
Last Name:SUTTON-WOLF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANINKA
Other - Middle Name:KAI
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:21600 HIGHWAY 99
Mailing Address - Street 2:SUITE 290
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8012
Mailing Address - Country:US
Mailing Address - Phone:425-778-0191
Mailing Address - Fax:
Practice Address - Street 1:21600 HIGHWAY 99
Practice Address - Street 2:SUITE 290
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8012
Practice Address - Country:US
Practice Address - Phone:425-778-0191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML20008112208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics