Provider Demographics
NPI:1417207424
Name:WEYRAUCH, KARL F (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:F
Last Name:WEYRAUCH
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 1:1511 6TH AVE
Mailing Address - Street 2:STE. 360
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101
Mailing Address - Country:US
Mailing Address - Phone:206-470-1925
Mailing Address - Fax:206-762-6355
Practice Address - Street 1:13123 121ST WAY NE
Practice Address - Street 2:SUITE D
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3051
Practice Address - Country:US
Practice Address - Phone:206-470-1925
Practice Address - Fax:425-820-6275
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00022829207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A07775Medicare UPIN