Individual
DR. TYSEN L WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 746-6348
Mailing address
2216 VINEYARD AVE, LEWISTON, ID 83501-6352
(208) 289-0425
(208) 568-9850
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M-15702
ID
208000000X
Pediatrics Physician
MD61156866
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730673419
—
ID
05
—
1730673419
—
WA
Enumeration date
06/18/2018
Last updated
04/15/2025
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