Provider Demographics
NPI:1700848355
Name:PIASECKI, JUSTIN H (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:H
Last Name:PIASECKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9515 64TH ST NW STE 310
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-5631
Mailing Address - Country:US
Mailing Address - Phone:253-509-4438
Mailing Address - Fax:888-843-2412
Practice Address - Street 1:11511 CANTERWOOD BLVD STE 310
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-5820
Practice Address - Country:US
Practice Address - Phone:253-858-5040
Practice Address - Fax:888-843-2412
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2020-05-01
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Provider Licenses
StateLicense IDTaxonomies
WAMD00049097208200000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery