MEDICARE: DR. MERRELL THAMES WISEMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD00025137	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WI7556	OTHER	WA	BLUE SHIELD VM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	US4590191	OTHER	WA	AETNA SPECIALIST PIN

General Provider Information

NPI Number	:	1528175882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERRELL THAMES WISEMAN M.D.

Provider Business Mailing Address
First Line	:	1810 34TH AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-3342
Country	:	US
Telephone Number	:	206-323-3765
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 SAND POINT WAY NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-3901
Country	:	US
Telephone Number	:	206-987-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	08/10/2009

Similar Medicare Providers

1982546347 — RELON DONATO CHICHESTER MD
Practice Location Address:

4800 SAND POINT WAY NE # OC.7830
SEATTLE, WA
98105-3901

Practice Phone: 206-987-2525
Practice Fax:

1447589700 — SATHISH MALLENAHALLI CHIKKABYRAPPA MBBS
Practice Location Address:

4800 SAND POINT WAY NE
SEATTLE, WA
98105-3901

Practice Phone: 206-987-2000
Practice Fax:

1891791448 — DR. ERIC M HARVEY PHARMD
Practice Location Address:

4800 SAND POINT WAY NE
SEATTLE, WA
98105-3901

Practice Phone: 206-987-1990
Practice Fax: 206-987-2224

1801893086 — DR. RICHARD ALOYSIUS MOLTENI M.D.
Practice Location Address:

4800 SAND POINT WAY NE
SEATTLE, WA
98105-3901

Practice Phone: 206-987-2005
Practice Fax: 206-987-3638

1205835162 — LESLIE R WALKER M.D.
Practice Location Address:

4800 SAND POINT WAY NE
SEATTLE, WA
98105-3901

Practice Phone: 206-987-2000
Practice Fax:

1114915097 — MS. LINDA A. RAMSDELL M.S.
Practice Location Address:

4800 SAND POINT WAY NE , M2-9
SEATTLE, WA
98105-3901

Practice Phone: 206-987-2663
Practice Fax: 206-987-2495

1821087404 — DR. ARI H POLLACK MD
Practice Location Address:

4800 SAND POINT WAY NE # OC.9820
SEATTLE, WA
98105-3901

Practice Phone: 206-987-2524
Practice Fax: 206-987-3626

Directions to “ DR. MERRELL THAMES WISEMAN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.