David E Wisner, M.D

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD00016552025209 Issued in WA

Practice address

470 Birchwood Ave
Bellingham, WA 98225-1781

Phone

(360) 676-1610

Fax

(360) 676-2459

NPI assigned

Mar 10, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1720056245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BIRCHWOOD AVE",
            "address_2": "SUITE C",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251704",
            "telephone_number": "360-676-1610",
            "fax_number": "360-676-2459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 BIRCHWOOD AVE",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251781",
            "telephone_number": "360-676-1610",
            "fax_number": "360-676-2459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNER",
        "first_name": "DAVID",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00016552025209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1807700",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Cherie Wipf, COTA
• Leigh Wirth, LICSW
• Shannon Leigh Wisbey
• Beckie Lavern Wisdom
• Olivia Wise, LMT
• Steven P. Wisner, M.D.
• Angela Wistrick, OTR
• Melissa Ann Witecki, DDS
• Victoria Witrak
• Laura R Witt, LMHC

• Specialist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.