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Individual

DR. MIKE DAVID WERNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3432 S BAY RD NE, OLYMPIA, WA 98506-2958
(360) 493-4688
Mailing address
5424 HEIGHTS LN NE, OLYMPIA, WA 98506-1872
(360) 753-1372

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00041419
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD 00041419
WA STATE DEPARTMENT OF HEALTH PHYSICIAN LICENSE
WA
Enumeration date
10/20/2010
Last updated
10/20/2010
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