Provider Demographics
NPI:1396009254
Name:WEEBER, MOLLY F (CNM)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:F
Last Name:WEEBER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:EC
Other - Last Name:FINLAYSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:7650 SW BEVELAND RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8692
Mailing Address - Country:US
Mailing Address - Phone:503-601-3615
Mailing Address - Fax:503-646-1683
Practice Address - Street 1:9555 SW BARNES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6663
Practice Address - Country:US
Practice Address - Phone:503-292-3577
Practice Address - Fax:503-292-3947
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201407282RN163W00000X
NYF001437367A00000X
OR201407283NP-PP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR186789OtherMEDICARE PTAN
OR500697504Medicaid