Wibisono, Esravila Ariya

Wibisono, Esravila Ariya is an individual health care provider with primary practice located at 10004 204Th Ave E Ste 2200 , Bonney Lake WA 98391-6537. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wibisono, Esravila Ariya can be contacted via phone (253) 447-3300.

Contact Information

Primary practice address
10004 204Th Ave E Ste 2200 Bonney Lake WA 98391-6537
Phone: (253) 447-3300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 06-0646844 Connecticut
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD61603415 Washington

Profile Details

NPI number 1972233708
LBN Legal business name Wibisono, Esravila Ariya
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2022
Last updated Jul 31st, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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