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General NPI Number Information
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NPI Number | 1891827739
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Entity Type | Individual
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Provider Name | JANICE K. WIEMEYER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 109 NORTH BEACH ROAD SUITE 6
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City | EASTSOUND
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State | WA
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Zip | 98245-1587
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Country | US
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Telephone | 360-376-4346
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1587
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City | EASTSOUND
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State | WA
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Zip | 98245-1587
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Country | US
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Telephone | 360-376-4346
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY2221
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 107649-2501
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License Number State | UT
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