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Individual

MRS. CYNTHIA SUE WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, APN-C

Contact information

Practice address
9300 SE 91 AVE., SUITE 400, PORTLAND, OR 97086
(503) 635-4148
(503) 699-7382
Mailing address
9300 SE 91 AVE., SUITE 400, PORTLAND, OR 97086
(503) 635-4148
(503) 699-7382

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200950034NP
OR
363LA2200X
Adult Health Nurse Practitioner
209.007285
IL

Other

Enumeration date
10/08/2008
Last updated
11/29/2012
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