BRENT WIEDERHOLD, MD

Family Medicine

Active Individual
NPI: 1356915417

Practice Address

14410 SE PETROVITSKY RD STE 104
Renton, WA 98058

Phone: (425) 690-3405

Specialties

Specialty Code Primary License
Student in an Organized Health Care Education/Training Program 390200000X No -
Family Medicine 207Q00000X Yes MD61430168 (WA)

Frequently Asked Questions

NPI 1356915417 is the National Provider Identifier for BRENT WIEDERHOLD, MD, a Family Medicine provider located in Renton, WA. This NPI was enumerated on May 13, 2021.
BRENT WIEDERHOLD, MD practices at 14410 SE PETROVITSKY RD STE 104, Renton, WA 98058.

Quick Facts

NPI
1356915417
Type
Individual
Enumerated
May 13, 2021
Last Updated
Aug 7, 2025

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