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General NPI Number Information
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NPI Number | 1285938241
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Entity Type | Organization
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Legal Business Name | CHUCK WEISSER, PHD. PC
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 12/21/2016
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Provider Practice Location Address
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Address Line | 754 OFFICERS ROW
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City | VANCOUVER
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State | WA
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Zip | 98661-3845
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Country | US
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Telephone | 360-993-2939
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Fax | 360-993-1060
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Provider Business Mailing Address
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Address Line | 754 OFFICERS ROW
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City | VANCOUVER
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State | WA
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Zip | 98661-3845
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Country | US
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Telephone | 360-993-2939
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Fax | 360-993-1060
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHUCK WEISSER
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Credential | PHD.
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Telephone | 360-993-2939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY00001409
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License Number State | WA
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