Organization
WEBER PEDIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYSEN WEBER MD (OWNER)
(971) 209-8219
Entity
Organization
Contact information
Practice address
2216 VINEYARD AVE, LEWISTON, ID 83501-6352
(971) 209-8219
Mailing address
901 22ND AVE, CLARKSTON, WA 99403-3147
(971) 209-8219
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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