Individual
GERARD P. WYGANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12800 BOTHELL EVERETT HWY, SUITE 160, EVERETT, WA 98208-6642
(425) 316-5180
(425) 316-5181
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 366-2983
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00015798
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1737402
—
WA
Enumeration date
09/27/2006
Last updated
02/13/2015
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