Individual
KATHLEEN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 NE 92ND AVE, VANCOUVER, WA 98664-3225
(360) 514-2500
(360) 514-3590
Mailing address
600 NE 92ND AVE, VANCOUVER, WA 98664-3225
(360) 514-2500
(360) 514-3590
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7728
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217679
—
OR
Enumeration date
03/28/2007
Last updated
07/08/2007
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