Individual
MICHELLE ELISE WIESE
Active
Individual
MICHELLE ELISE WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01093232A
IN
2084P0800X
Psychiatry Physician
MD60988236
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003348343
—
WA
Enumeration date
03/28/2017
Last updated
06/28/2024
Update your record
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