Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN60074145 | WA |
NPI | 1447484787 |
---|---|
Provider Name | Hanna Wietecha |
First Address | Kirkland, WA 98034-2242 |
Second Address | Kirkland, WA 98034-2242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2009 |
Last Update Date | 13/05/2009 |