Individual
IVY WEAKLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4311 11TH AVE NE STE 200, SEATTLE, WA 98105-6367
(206) 616-4001
Mailing address
9500 INDEPENDENCE DR, STE 900, ANCHORAGE, AK 99507-4686
(907) 522-1341
(907) 522-1343
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
115459
AK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/15/2016
Last updated
11/29/2016
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