Individual
AGNIESZKA J. NIEMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
558 N 5TH AVE, SEQUIM, WA 98382-3079
(360) 681-6900
(360) 681-6222
Mailing address
558 NORTH 5TH AVE, SEQUIM, WA 98382
(360) 681-6900
(360) 681-6222
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00048475
WA
207ND0101X
MOHS-Micrographic Surgery Physician
MD00048475
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699947200
NPI GROUP
WA
01
—
G8873508
MEDICARE GROUP PTAN
WA
01
—
G8873509
MEDICARE INDIVIDUAL PTAN
WA
Enumeration date
12/10/2007
Last updated
09/21/2023
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