Individual
WESLEY D WEIDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8301 161ST AVE NE STE 202, REDMOND, WA 98052-3858
(425) 979-4339
Mailing address
2912 SPRINGBORO W, MORAINE, OH 45439-1674
(937) 855-6006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61039111
WA
363AM0700X
Medical Physician Assistant
50.005416RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0328080
—
OH
Enumeration date
01/12/2018
Last updated
05/07/2025
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