Basic Information
| Provider Information | |||||||||
| NPI: | 1417207424 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEYRAUCH | ||||||||
| FirstName: | KARL | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1511 6TH AVE | ||||||||
| Address2: | STE. 360 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064701925 | ||||||||
| FaxNumber: | 2067626355 | ||||||||
| Practice Location | |||||||||
| Address1: | 13123 121ST WAY NE | ||||||||
| Address2: | SUITE D | ||||||||
| City: | KIRKLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980343051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064701925 | ||||||||
| FaxNumber: | 4258206275 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2012 | ||||||||
| LastUpdateDate: | 11/10/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD00022829 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.