Individual
MARIAH WEIGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6099
(541) 382-4900
Mailing address
PO BOX 6048, BEND, OR 97708-6048
(541) 382-4900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA208184
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500803288
—
OR
Enumeration date
06/15/2018
Last updated
09/15/2023
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