Individual
MR. DENISON F WIEDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
136 N MAIN AVE, WHITE SALMON, WA 98672-1149
(786) 271-2568
Mailing address
PO BOX 2290 PMB 204, WHITE SALEM, WA 98672
(786) 271-2568
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
25542
OR
225700000X
Massage Therapist
Primary
61034962
WA
Other
Enumeration date
01/23/2021
Last updated
02/12/2024
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