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General NPI Number Information
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NPI Number | 1598916546
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Entity Type | Individual
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Provider Name | CYNTHIA SUE WEAVER RN, APN-C
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Gender | Female
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 11/29/2012
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Provider Practice Location Address
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Address Line | 9300 SE 91 AVE. SUITE 400
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City | PORTLAND
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State | OR
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Zip | 97086
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Country | US
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Telephone | 503-635-4148
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Fax | 503-699-7382
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Provider Business Mailing Address
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Address Line | 9300 SE 91 AVE. SUITE 400
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City | PORTLAND
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State | OR
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Zip | 97086
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Country | US
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Telephone | 503-635-4148
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Fax | 503-699-7382
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 200950034NP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209.007285
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License Number State | IL
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