Individual
MARISSA WEIDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
940 NORTHGATE DR, RICHLAND, WA 99352-3505
(509) 542-4571
Mailing address
3810 ATLANTA LN, PASCO, WA 99301-8591
(509) 713-3176
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
WA
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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