Robin Kate Bevin Wiesner, L.AC

Individual provider Active NPI Acupuncturist · Stevenson, WA

NPI 1225612435 · NPPES record last updated Dec 29, 2022

Key facts

NPI
1225612435
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
AC61019238 (WA)
Practice address
640 NE Major St
Stevenson, WA 98648-6347
Phone
(631) 258-6493
NPI assigned
May 12, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LAC0100030AZMDAcupuncturist
AC204758ORMDAcupuncturist
AC61019238WAMDAcupuncturist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC204758 OR
Acupuncturist 171100000X LAC0100030 AZ
Acupuncturist 171100000X AC61019238 WA Yes

Addresses

Primary practice location

640 NE Major St
Stevenson, WA 98648-6347

Mailing address

PO Box 1351
Stevenson, WA 98648-1351
Phone (631) 258-6493

Other practice location 1

2901 E Burnside St
Portland, OR 97214-1831
Phone (503) 238-5203

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address rwiesner@quest-center.org Direct

Other providers in Stevenson, WA

All providers in Stevenson, WA · Acupuncturist in Washington

Sources for this page

Verify at the official NPI Registry.