Individual
MR. AUSTIN WEIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2923 E 29TH AVE, SPOKANE, WA 99223
(888) 227-3312
(509) 227-7070
Mailing address
PO BOX 2928, PORTLAND, OR 97208-2928
(425) 207-5155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61286749
WA
363AM0700X
Medical Physician Assistant
57014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57014
PHYSICIAN ASSISTANT LICENSE
CA
01
—
PA61286749
PHYSICIAN ASSISTANT LICENSE
WA
Enumeration date
03/28/2019
Last updated
07/03/2025
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