Individual
MEGAN RAE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
244 NW KINGWOOD AVE, REDMOND, OR 97756-1688
(541) 322-7500
Mailing address
2577 NE COURTNEY DR, BEND, OR 97701-7752
(541) 322-7500
(541) 322-7565
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14-03-24
OR
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L11949
OR
171M00000X
Case Manager/Care Coordinator
14-03-24
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195164
—
OR
Enumeration date
01/14/2013
Last updated
12/10/2024
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