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ESRAVILA WIBISONO, MD

MD

Internal Medicine Physician

NPI: 1972233708IndividualAccepts Medicare

Specialties, Licenses & Credentials

Student in an Organized Health Care Education/Training Program

Student in an Organized Health Care Education/Training Program

Code: 390200000X

06-0646844(CT)
Internal Medicine PhysicianPrimary

Internal Medicine

Code: 207R00000X

MD61603415(WA)

CMS Specialties

Education

OTHER

Class of 2018

Contact & Hours

Via practice · 2 locations total

Address
10004 204TH AVE E STE 2200
BONNEY LAKE, WA 98391

Quick Facts

NPI
1972233708
Entity Type
Individual
Gender
Male
Medicare
Accepted
Specialties
2
Locations
2
Years in Practice
8

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