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Individual

DR. MARY H WIENEKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
823 NE 65TH ST, SEATTLE, WA 98115-5539
(206) 940-8861
Mailing address
823 NE 65TH ST, SEATTLE, WA 98115-5539
(206) 940-8861

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PSY 13834
CA
103TC0700X
Clinical Psychologist
Primary
PY 3127
WA

Other

Enumeration date
03/05/2007
Last updated
07/08/2007
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