Individual
BENJAMIN J WIECZOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
902 NE 65TH ST, SEATTLE, WA 98115-5562
(206) 267-0863
(206) 267-0814
Mailing address
1120 NW 63RD ST, SEATTLE, WA 98107-2239
(206) 484-5983
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00020216
WA
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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