Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | A130738 | CA |
N | 208200000X | Surgeon | MD60918827 | WA |
N | 208600000X | Surgeon | MD60918827 | WA |
NPI | 1235365990 |
---|---|
Provider Name | Keri Elizabeth Weigle |
First Address | Anacortes, WA 98221-2595 |
Second Address | Los Angeles, CA 90095-9593 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2009 |
Last Update Date | 26/06/2019 |