Joseph M. Wentzell
MOHS-Micrographic Surgeon
15906 Mill Creek Blvd Suite 105
Mill Creek
, Washington 98012-1797
Joseph M. Wentzell
MOHS-Micrographic Surgeon
15906 Mill Creek Blvd Suite 105
Mill Creek
, Washington 98012-1797
(425) 385-2009
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About
Features
Specialties
- MOHS-Micrographic Surgeon
Languages spoken
- English
Location
First Address
- Joseph M. Wentzell
- 15906 Mill Creek Blvd Suite 105
- Mill Creek, WA
- Zip : 98012-1797
- Phone : (425) 385-2009
Second Address
- Joseph M. Wentzell
- 15906 Mill Creek Blvd Suite 105
- Mill Creek, WA
- Zip : 98012-1797
- Phone : (425) 385-2009
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207ND0101X | MOHS-Micrographic Surgeon | 6255 | MT |
National Provider Identifier
| NPI | 1053478396 |
|---|---|
| Provider Name | Joseph M. Wentzell |
| First Address | Mill Creek, WA 98012-1797 |
| Second Address | Mill Creek, WA 98012-1797 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/01/2007 |
| Last Update Date | 23/01/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000096270 | BCBS PIN (01) | WY |
| 0011305 | MDCD PIN (01) | MT |
| 100431000 | MDCD PIN (01) | WY |
| C65805 | (02) | MT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.