Lawrence Wissow, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD60909909 Issued in WA

Practice address

4800 Sand Point Way NE
Seattle, WA 98105-3901

Phone

(206) 987-0000

NPI assigned

Jun 20, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwissow55890@direct.seattlechildrens.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seattle Children'S Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment NPD
• The Association of Chrmc and University Physicians

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1255449963
  Medicare reassignment NPD
• The Association of University Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1023041159
  Medicare reassignment NPD
• Association of CHMC and University Physicians

  • Pediatrics Physician
  • Richland, WA
  • NPI 1851680664
  NPD
• Seattle Childrens Hospital

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• Seattle Children'S Hospital

  • Home Infusion Agency
  • Bothell, WA
  • NPI 1245383348
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1760428742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSOW",
        "first_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD60909909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760428742",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacey Cassandra Wisniewska
• Bethany Lee Wisotzkey, M.D.
• Brent E Wisse, MD
• Kyann R Wisse, PHARMD
• Erik Wissner, M.D.
• Nancy Wisti, MA
• Miroslawa Witalis, N.D.
• Elise Witek, MA LMHCA
• With a Little Help, Inc
• Kerry Lauren Witherell, AU.D

• Child & Adolescent Psychiatry Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Child & Adolescent Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.