Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lola Mudgistratova Wise, MD

Individual provider Emergency Medicine Physician · NPI 1609309533

Lola Mudgistratova Wise, MD is an Emergency Medicine in Renton, Washington. Graduated from University of Washington School of Medicine in 2017, 9 years ago. Practices with Puget Sound Physicians PLLC, a 46-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
9
Trained at
University of Washington School of Medicine
Licensed in
WA
In the registry since
2017
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

400 S 43rd St
Renton, WA 98055-5714
Phone: (206) 661-2563
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence MD60963016 (WA)

Record details

NPI number1609309533
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 7, 2017
Last updated in NPPESJanuary 31, 2025
Certification dateJanuary 31, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Puget Sound Physicians Pllc — 46 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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