Individual
KIRK L WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5050 NE HOYT ST STE 315, PORTLAND, OR 97213-2982
(503) 215-8580
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD17310
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062661
—
OR
Enumeration date
07/03/2006
Last updated
02/16/2021
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