Individual
ANNE KC WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC
Contact information
Practice address
4029 NE TILLAMOOK ST, PORTLAND, OR 97212-5341
(503) 249-0455
Mailing address
1595 SHADOW WOOD DR, WEST LINN, OR 97068-9711
(503) 638-9380
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12125
OR
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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