Healthcare Provider Details

I. General information

NPI: 1477492403
Provider Name (Legal Business Name): ANN WEILAND PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 CHASE AVE
WALLA WALLA WA
99362-2924
US

IV. Provider business mailing address

356 S 8TH ST APT 3
KALAMA WA
98625-8732
US

V. Phone/Fax

Practice location:
  • Phone: 509-516-3620
  • Fax:
Mailing address:
  • Phone: 360-849-9612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT60588033
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: