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Individual

ANDREA C WEBER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
709 NE 5TH ST, GRESHAM, OR 97030
(503) 734-7508
(503) 664-4164
Mailing address
709 NE 5TH ST, GRESHAM, OR 97030-7439
(503) 734-7508
(503) 664-4164

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC156402
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
500698682
DMAP
Enumeration date
03/07/2012
Last updated
01/23/2020
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