Individual
KELLY B WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1330 ROCKEFELLER AVE, EVERETT, WA 98201-1684
(425) 339-5476
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 258-3903
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD00038761
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007095
—
WA
Enumeration date
09/16/2006
Last updated
11/14/2025
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