Individual
MR. ZACHARY CROFFORD WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
21616 76TH AVE W STE 201A, EDMONDS, WA 98026-7512
(425) 673-3400
(425) 673-3401
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA60922697
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013482892
—
WA
Enumeration date
10/09/2018
Last updated
09/18/2020
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