Individual
STEVEN P. WISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4545 CORDATA PKWY, BELLINGHAM, WA 98226-7123
(360) 738-2200
(360) 752-5679
Mailing address
PO BOX 5096, BELLINGHAM, WA 98227-5096
(360) 738-2200
(360) 752-5679
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00019200
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0229988
L&I AND CRIME VICTIMS
WA
01
—
10804
REGENCE
WA
05
—
1437155413
—
WA
05
—
1904408
—
WA
01
—
4587498
AETNA
WA
Enumeration date
06/23/2005
Last updated
11/19/2010
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