Organization
CASCADE INTERNAL MEDICINE PS
Active
Other names
John Daniel Wanwig MD
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DANIEL WANWIG MD (PHYSICIAN PRESIDENT)
(253) 272-3031
Entity
Organization
Contact information
Practice address
1901 SO UNION, ALLENMORE MEDICAL CENTER STE A305, TACOMA, WA 98405
(253) 272-3031
(253) 272-9449
Mailing address
1901 SO UNION, ALLENMORE MEDICAL CENTER STE A305, TACOMA, WA 98405
(253) 272-3031
(253) 272-9449
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
12582
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1047786
—
WA
01
—
1300029
MEDICAID MEDICAL
—
01
—
21793
LABOR & INDUSTRIES
WA
01
—
8914379
CRIME VICTIMS
—
01
—
WA7229
REGENCE
—
Enumeration date
03/07/2006
Last updated
08/22/2020
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