Provider Demographics
NPI:1801267273
Name:WIEAND, SUSANNE (RN)
Entity type:Individual
Prefix:
First Name:SUSANNE
Middle Name:
Last Name:WIEAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4347 SW CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-2433
Mailing Address - Country:US
Mailing Address - Phone:206-299-1915
Mailing Address - Fax:206-299-1977
Practice Address - Street 1:2101 E YESLER WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5959
Practice Address - Country:US
Practice Address - Phone:206-299-1915
Practice Address - Fax:206-299-1977
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00084762163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal