Individual
MS. MADISON RENEE WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RS
Contact information
Practice address
3436 MARY ELDER RD NE, OLYMPIA, WA 98506-5050
(360) 528-2590
Mailing address
2023 BETHEL ST NE, OLYMPIA, WA 98506-3377
(360) 867-8510
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CG60972061
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110043589004
—
WA
Enumeration date
10/23/2019
Last updated
10/23/2019
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