Individual
CRYSTAL WEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
24800 SE STARK ST, GRESHAM, OR 97030-3378
(503) 674-1122
Mailing address
3311 HARVEY ST, APT E, MADISON, WI 53705-3456
(608) 215-5168
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
155139
OR
207P00000X
Emergency Medicine Physician
MD60617983
WA
Other
Enumeration date
05/18/2009
Last updated
02/04/2022
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