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Individual

ANDREW RICHARD WIESEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
MAMC, ATTN: MCHJ-PV (LTC WIESEN), TACOMA, WA 98431-0001
(253) 968-4475
Mailing address
13501 152ND STREET CT E, PUYALLUP, WA 98374-9244
(253) 968-4475

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33777
WI
2083P0901X
Public Health & General Preventive Medicine Physician
33777
WI

Other

Enumeration date
01/25/2006
Last updated
09/11/2025
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