Individual
MICHAEL AARON WAUTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
240 W FRONT ST STE A, PORT ANGELES, WA 98362-2609
(360) 452-7891
(360) 452-8087
Mailing address
240 W FRONT ST STE A, PORT ANGELES, WA 98362-2609
(360) 452-7891
(360) 452-8087
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60752412
WA
207Q00000X
Family Medicine Physician
MRM-1400
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2082091
—
WA
Enumeration date
05/09/2014
Last updated
10/11/2024
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