Individual
STAN W PNIEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 ALDER ST, SOUTH BEND, WA 98586
(360) 642-3181
Mailing address
PO BOX 2450, CORVALLIS, OR 97339-2450
(541) 758-5047
(541) 758-3713
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00038267
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1111152
—
WA
Enumeration date
06/23/2006
Last updated
08/06/2010
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