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Individual
DAVID MICHAEL WISDOM
Active
Individual
DAVID MICHAEL WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61471148
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1138002
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
—
Enumeration date
09/04/2018
Last updated
10/17/2025
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