Individual
RAE WISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4603 NE ST JOHNS RD, SUITE C, VANCOUVER, WA 98661-2587
(360) 254-1814
(360) 254-1828
Mailing address
4603 NE ST JOHNS RD, SUITE C, VANCOUVER, WA 98661-2587
(360) 254-1814
(360) 254-1828
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
WA00031984
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1090455
—
WA
01
—
601-864-528
BUSINESS ID NUMBER
WA
Enumeration date
12/11/2006
Last updated
04/30/2014
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