Individual
EVAN JONATHON WEBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
13228 SE BROOKLYN CT, PORTLAND, OR 97236-3035
(917) 583-5128
Mailing address
13228 SE BROOKLYN CT, PORTLAND, OR 97236-3035
(917) 583-5128
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10024561
OR
Other
Enumeration date
04/16/2024
Last updated
05/13/2024
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