Individual
KEITH ALLEN WEISSINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7424 BRIDGEPORT WAY W, SUITE 103, LAKEWOOD, WA 98499-8120
(253) 581-2111
(253) 581-2712
Mailing address
7424 BRIDGEPORT WAY W, SUITE 103, LAKEWOOD, WA 98499-8120
(253) 581-2111
(253) 581-2712
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00030882
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1082643
—
WA
01
—
187470
LABOR & INDUSTRY
WA
01
—
8925990
CRIME VICTIMS
WA
Enumeration date
08/01/2006
Last updated
08/17/2011
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