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Individual

GEORG KRISTOFER WIESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
34509 9TH AVE S STE 204, FEDERAL WAY, WA 98003-8708
(253) 835-5510
(253) 835-5511
Mailing address
34509 9TH AVE S STE 204, FEDERAL WAY, WA 98003-8708
(253) 835-5510
(253) 835-5511

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD61684844
WA
208600000X
Surgery Physician
ME128351
FL

Other

Enumeration date
04/15/2014
Last updated
07/15/2025
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