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NPI Code Detail

MEDICARE: MONIKA WEITZEL MSW

MEDICARE: MONIKA WEITZEL MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerA5401OR

General Provider Information

NPI Number : 1750993051
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONIKA WEITZEL MSW
Provider Business Mailing Address
First Line : 7704 N HEREFORD AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97203-3434
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7704 N HEREFORD AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97203-3434
Country : US
Telephone Number : 503-780-9243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2020
Last Update Date : 10/31/2023

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