Healthcare Provider Details

I. General information

NPI: 1659183200
Provider Name (Legal Business Name): ANTONIA WEBER CSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TONIA WEBER CSWA

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 DIVISION ST STE 102
OREGON CITY OR
97045-1589
US

IV. Provider business mailing address

521 NE CADEN CT
ESTACADA OR
97023-7454
US

V. Phone/Fax

Practice location:
  • Phone: 503-334-3035
  • Fax: 503-961-9212
Mailing address:
  • Phone: 503-516-9395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberA16046
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: