Provider Demographics
NPI:1558466029
Name:EISSMANN, EDWARD W (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:W
Last Name:EISSMANN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:328 S STILLAGUAMISH AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1660
Mailing Address - Country:US
Mailing Address - Phone:360-435-6641
Mailing Address - Fax:360-618-7663
Practice Address - Street 1:328 S STILLAGUAMISH AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1660
Practice Address - Country:US
Practice Address - Phone:360-435-6641
Practice Address - Fax:360-618-7663
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2023-01-30
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Provider Licenses
StateLicense IDTaxonomies
WA36363207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4327Medicare UPIN