Provider Demographics
NPI:1366428369
Name:CUENCA, ROSELYNN WEE SIM (MD, MPH)
Entity type:Individual
Prefix:
First Name:ROSELYNN
Middle Name:WEE SIM
Last Name:CUENCA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:ROSELYNN
Other - Middle Name:WEE
Other - Last Name:SIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:1910 MERIDIAN ST S
Mailing Address - Street 2:STE A
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-7531
Mailing Address - Country:US
Mailing Address - Phone:253-848-2303
Mailing Address - Fax:
Practice Address - Street 1:1910 MERIDIAN ST S
Practice Address - Street 2:STE A
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-7531
Practice Address - Country:US
Practice Address - Phone:253-848-2303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60235480208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics