Individual
BRIAN WISMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
915 CAPITOL WAY S APT 15, OLYMPIA, WA 98501-1231
(253) 254-6336
Mailing address
915 CAPITOL WAY S APT 15, OLYMPIA, WA 98501-1231
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/11/2025
Last updated
05/30/2026
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