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1356915417
BRENT JAMES WIEDERHOLD
RENTON, WA
NPI
1356915417
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-05-13
Last Update Date
2021-05-13
Business Address
BRENT JAMES WIEDERHOLD MD
3915 TALBOT RD S STE 401
RENTON, WA 98055-5738
Phone number: 425-690-3445
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Mailing Address
BRENT JAMES WIEDERHOLD MD
3600 LIND AVE SW SUITE 100 ATTN CREDENTIALING
RENTON, WA 98057-4970
Phone number: 425-690-2715
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