Individual
SCOTT ALAN WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 N INTERSTATE AVE, INTERSTATE MEDICAL OFFICE SOUTH, PORTLAND, OR 97227-1196
(503) 333-1615
(503) 331-6145
Mailing address
3500 N INTERSTATE AVE, INTERSTATE MEDICAL OFFICE SOUTH, PORTLAND, OR 97227-1196
(503) 333-1615
(503) 331-6145
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD17964
OR
Other
Enumeration date
10/11/2006
Last updated
07/13/2007
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