Individual provider · Type 1 NPI
Esravila Ariya Wibisono, MD
Internal Medicine Physician · Bonney Lake, WA
Practice location
10004 204th Ave E Ste 2200
Bonney Lake, WA 98391-6537
Other practice locations
- 56 Franklin St Ste 1, Waterbury, CT 06706-1281 · (203) 709-8685
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 06-0646844 (CT) |
| Internal Medicine Physician Primary | 207R00000X | MD61603415 (WA) |
Internal Medicine Physician: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medi…
Another provider at this address
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About NPI 1972233708
Esravila Ariya Wibisono, MD's National Provider Identifier is 1972233708, issued on Jun 14, 2022. The primary taxonomy on file is Internal Medicine Physician (207R00000X), and the practice location is in Bonney Lake, WA. The record was last updated on Jul 31, 2025.