Search › Washington › 207R00000X
Esravila Wibisono, MD
NPI 1972233708 · on the registry since 2022
Practice
- Address
- 10004 204th Ave E Ste 2200
Bonney Lake, WA 98391 - Phone
- (253) 447-3300
- Organisation at this address
- Rehan Bashar Dds Pllc
Multicare Health System
Multicare Health System
Multicare Health Systems
Apple Physical Therapy LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 70
Additional practice sites
- 56 Franklin St Ste 1, Waterbury, CT
Registry record
- Primary taxonomy
- 207R00000X
207R00000X
- Also registered as
- 390200000X
- Licence states on file
- CT, WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-07-31
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington