Provider Demographics
NPI:1831285873
Name:WICHER, JOHN BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRIAN
Last Name:WICHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1660 S COLUMBIAN WAY
Mailing Address - Street 2:S-111-PCC
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1532
Mailing Address - Country:US
Mailing Address - Phone:206-764-2733
Mailing Address - Fax:206-764-2936
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:S-111-PCC
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-764-2733
Practice Address - Fax:206-764-2936
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00026611207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine