Provider Demographics
NPI:1386623791
Name:SISSON, JOHN WHITING (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WHITING
Last Name:SISSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8385 LEEWARD AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEABECK
Mailing Address - State:WA
Mailing Address - Zip Code:98380-8816
Mailing Address - Country:US
Mailing Address - Phone:971-232-0063
Mailing Address - Fax:
Practice Address - Street 1:939 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3997
Practice Address - Country:US
Practice Address - Phone:360-417-7000
Practice Address - Fax:360-565-9241
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD-00047501207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine