Individual
MR. JACOB SCOTT WEIDERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
125 16TH AVE E, SEATTLE, WA 98112-5211
(206) 326-3000
Mailing address
125 16TH AVE E, SEATTLE, WA 98112-5211
(206) 326-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.60188423
WA
Other
Enumeration date
10/28/2010
Last updated
05/10/2021
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