Individual
DR. JAMES GREGORY SISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 E KING ST, CHEWELAH, WA 99109-0137
(509) 935-8711
(509) 935-4882
Mailing address
PO BOX 137, CHEWELAH, WA 99109-0137
(509) 935-8711
(509) 935-4882
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00032087
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123031
WA STATE L&I
WA
01
—
191826000
US DEPT OF LABOR
WA
05
—
8156788
—
WA
Enumeration date
12/11/2006
Last updated
06/18/2008
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