Provider Demographics
NPI:1730113218
Name:WEEKS, WENDY ALLYSON (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ALLYSON
Last Name:WEEKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34509 9TH AVE S
Mailing Address - Street 2:STE 208
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6700
Mailing Address - Country:US
Mailing Address - Phone:253-944-3278
Mailing Address - Fax:253-944-4345
Practice Address - Street 1:34509 9TH AVE S
Practice Address - Street 2:STE 208
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6700
Practice Address - Country:US
Practice Address - Phone:253-944-3278
Practice Address - Fax:253-944-4345
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-01735208600000X
WAMD00046199208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8907779OtherMEDICARE
WA0278847OtherSTATE L&I
0291743OtherL&I
WA8455735Medicaid
WA0226423OtherSTATE L&I
WA0226425OtherSTATE CRIME VICTIMS
WA8945566OtherSTATE CRIME VICTIMS
WA0223393OtherSTATE L&I
WA0291746OtherL&I
WA0226425OtherSTATE CRIME VICTIMS
WA0278847OtherSTATE L&I
WAG8869026Medicare PIN
WAG8869025Medicare PIN