| John Daniel Wanwig Md | |
|
1901 So Union Allenmore Medical Center Ste A305 Tacoma WA 98405 | |
| (253) 272-3031 | |
| (253) 272-9449 |
| Full Name | John Daniel Wanwig Md |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1901 So Union, Tacoma, Washington |
| Authorized Official Name and Position | John Daniel Wanwig (PHYSICIAN PRESIDENT) |
| Authorized Official Contact | 2532723031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John Daniel Wanwig Md 1901 So Union Allenmore Medical Center Ste A305 Tacoma WA 98405 Ph: (253) 272-3031 | John Daniel Wanwig Md 1901 So Union Allenmore Medical Center Ste A305 Tacoma WA 98405 Ph: (253) 272-3031 |
| NPI Number | 1700853983 |
|---|---|
| Provider Enumeration Date | 03/07/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3173613932 |
|---|---|
| Medicare Enrollment ID | O20071217000375 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700853983 | NPI | - | NPPES |
| 1047786 | Medicaid | WA | |
| 1300029 | Other | MEDICAID MEDICAL | |
| 21793 | Other | WA | LABOR & INDUSTRIES |
| 8914379 | Other | CRIME VICTIMS | |
| WA7229 | Other | REGENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 12582 (Washington) | Primary |
| Provider Name | John Daniel Wanwig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639360936 PECOS PAC ID: 9931006533 Enrollment ID: I20031212000587 |
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