Individual
DR. TYLER SCOTT WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1508 DIVISION ST STE 115, OREGON CITY, OR 97045-1584
(503) 656-0601
(503) 656-1389
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD194367
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2037635
—
WA
05
—
500707151
—
OR
Enumeration date
04/10/2014
Last updated
11/07/2024
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