Provider Demographics
NPI:1760971618
Name:WENDT, COLIN JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:JOSEPH
Last Name:WENDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 LAKE WASHINGTON BLVD NE STE 102
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7874
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:425-968-7047
Practice Address - Street 1:4040 LAKE WASHINGTON BLVD NE STE 102
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7874
Practice Address - Country:US
Practice Address - Phone:866-623-0411
Practice Address - Fax:425-968-7047
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD610708252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry