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Individual

DR. TIMOTHY M RIESENBERGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Mailing address
388 YPAO RD, TAMUNING, GU 96913-3701
(671) 646-8881

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
65745
TN
207P00000X
Emergency Medicine Physician
Primary
66176
AZ
207P00000X
Emergency Medicine Physician
C0654
KY
207P00000X
Emergency Medicine Physician
M-2172
GU
207P00000X
Emergency Medicine Physician
MD00044765
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1689616302
WA
Enumeration date
06/11/2006
Last updated
05/20/2022
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