Provider Demographics
NPI:1609049071
Name:WEISS, NICHOLAS TSVI (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:TSVI
Last Name:WEISS
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 1:2719 E MADISON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4752
Mailing Address - Country:US
Mailing Address - Phone:206-747-0724
Mailing Address - Fax:844-857-3175
Practice Address - Street 1:2719 E MADISON ST STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4752
Practice Address - Country:US
Practice Address - Phone:206-747-0724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA801482084P0800X, 2084P0804X
WAMD602297982084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry