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NPI Code Detail

MEDICARE: CHRISTOPHER HOUSTON WIEDLE JR.

MEDICARE: CHRISTOPHER HOUSTON WIEDLE JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207L00000XAnesthesiology Physician0101277868VA

General Provider Information

NPI Number : 1144782384
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER HOUSTON WIEDLE JR.
Provider Business Mailing Address
First Line : 10924 CHATHAM RIDGE WAY
Second Line :
City : SPOTSYLVANIA
State : VA
Zip : 22551-4683
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1959 NE PACIFIC ST
Second Line :
City : SEATTLE
State : WA
Zip : 98195-0001
Country : US
Telephone Number : 206-598-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2019
Last Update Date : 03/09/2026

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Directions to “ CHRISTOPHER HOUSTON WIEDLE JR. ” Practice Location

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