Provider Demographics
NPI:1750350443
Name:WAIBLINGER, BRIAN E (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:WAIBLINGER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1400 E KINCAID ST
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-428-2500
Mailing Address - Fax:360-428-6485
Practice Address - Street 1:1415 E KINCAID ST
Practice Address - Street 2:BEHAVIORAL HEALTH
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4126
Practice Address - Country:US
Practice Address - Phone:360-424-2511
Practice Address - Fax:360-424-2522
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2015-03-03
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Provider Licenses
StateLicense IDTaxonomies
WAMD000380312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB16371Medicare PIN
WAH20220Medicare UPIN