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Individual

ANTHONY EDGAR WEIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A12910
CSWA
OR
Enumeration date
01/10/2022
Last updated
01/10/2022
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