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General NPI Number Information
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NPI Number | 1780058743
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Entity Type | Individual
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Provider Name | JOANNA WIMER
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Gender | Female
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Dates
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Enumeration Date | 11/13/2015
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 1035 11TH AVE
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City | LONGVIEW
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State | WA
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Zip | 98632-2505
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Country | US
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Telephone | 360-696-5103
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Fax | 360-729-3451
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Provider Business Mailing Address
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Address Line | 400 NE MOTHER JOSEPH PL
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City | VANCOUVER
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State | WA
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Zip | 98664-3200
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60616019
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License Number State | WA
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