Weber, Tysen L

Weber, Tysen L is an individual health care provider with primary practice located at 2315 8Th St , Lewiston ID 83501-7301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Weber, Tysen L can be contacted via phone (208) 746-1383.

Contact Information

Primary practice address
2315 8Th St Lewiston ID 83501-7301
Phone: (208) 746-1383
Fax: (208) 746-6348
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD61156866 Washington
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M-15702 Idaho

Profile Details

NPI number 1730673419
LBN Legal business name Weber, Tysen L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2018
Last updated Jul 21st, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730673419 NPPES
Washington MEDICAID 1730673419
Washington MEDICAID 1730673419

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