| Weller Neurology LLC | |
|
24900 Se Stark St Ste 211 Gresham OR 97030-3382 | |
| (503) 669-0435 | |
| (503) 618-1859 |
| Full Name | Weller Neurology LLC |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 24900 Se Stark St Ste 211, Gresham, Oregon |
| Authorized Official Name and Position | Kirk L Weller (OWNER) |
| Authorized Official Contact | 5036690453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Weller Neurology LLC 24900 Se Stark St Ste 211 Gresham OR 97030-3382 Ph: (503) 669-0435 | Weller Neurology LLC 24900 Se Stark St Ste 211 Gresham OR 97030-3382 Ph: (503) 669-0435 |
| NPI Number | 1659891455 |
|---|---|
| Provider Enumeration Date | 06/22/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659891455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | MD17310 (Oregon) | Primary |
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