Gerald Carl Wieder

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN00132339 Issued in WA

Practice address

4130 SW 325TH St
Federal Way, WA 98023-2427

Phone

(206) 234-8384

NPI assigned

Aug 23, 2018

Last updated

Aug 23, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1487135844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 SW 325TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232427",
            "telephone_number": "206-234-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 SW 325TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232427",
            "telephone_number": "206-234-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDER",
        "first_name": "GERALD",
        "middle_name": "CARL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00132339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julian Whitford, PT
• Wholistic Works LLC (LaVida Massage of Federal Way)
• Courtney Whyte
• Jessica Wi
• Craig James Wical
• Georg Kristofer Wiese, M.D.
• Charmian Louise Wilcox, LMP
• Alison Katherine Willam, M.D.
• Debra Marie Willems, LMP
• Khalia Monique Williams-O'Neal

• Registered Nurse in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.