Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD00034336 | WA |
Y | 111NI0900X | Internist | MD00034336 | WA |
N | 207RA0401X | Internist - Addiction Medicine | MD00034336 | WA |
N | 207RS0012X | Sleep Medicine | MD00034336 | WA |
NPI | 1215092507 |
---|---|
Provider Name | Michael John Schiesser |
First Address | Bellevue, WA 98005-1946 |
Second Address | Tonasket, WA 98855-9286 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 11/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0160250 | L & I (01) | WA |
1215092507 | (05) | WA |
44255C | REGENCE (01) | |
5128509 | AETNA (01) | |
G59539 | (02) |