Individual
MICHAEL J WYMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99205-4805
(509) 474-3131
Mailing address
PO BOX 12229, WESTMINSTER, CA 92685-2229
(688) 432-2088
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00025182
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043553
—
WA
Enumeration date
08/04/2006
Last updated
12/16/2009
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