LOLA MUDGISTRATOVA WISE

RENTON, WA
NPI1609309533
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: WA  MD60963016)
Enumeration Date2017-04-07
Last Update Date2025-01-31
Business Address
LOLA MUDGISTRATOVA WISE MD
400 S 43RD ST
RENTON, WA 98055-5714
Phone number: 206-661-2563
Mailing Address
LOLA MUDGISTRATOVA WISE MD
3321 104TH PL SE
EVERETT, WA 98208-4538
Phone number: 206-661-2563