Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | OR |
NPI | 1144246299 |
---|---|
Provider Name | Ms. Shelley Lynn Weid |
First Address | Newberg, OR 97132 |
Second Address | Newberg, OR 97132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
029010 | (05) | OR |
S48757 | (02) | OR |