Organization
CASCADE INTERNAL MEDICINE PS
Active
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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