Provider Demographics
NPI:1679636484
Name:WEIH, HANS EDWIN (PA)
Entity Type:Individual
Prefix:
First Name:HANS
Middle Name:EDWIN
Last Name:WEIH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78075 HIGH PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:OAKRIDGE
Mailing Address - State:OR
Mailing Address - Zip Code:97463-9603
Mailing Address - Country:US
Mailing Address - Phone:541-782-4068
Mailing Address - Fax:541-782-4113
Practice Address - Street 1:48134 HWY 58
Practice Address - Street 2:
Practice Address - City:OAKRIDGE
Practice Address - State:OR
Practice Address - Zip Code:97463
Practice Address - Country:US
Practice Address - Phone:541-782-4068
Practice Address - Fax:541-782-4113
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA00421363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORA01657Medicare UPIN
ORR0000BLBVQMedicare ID - Type UnspecifiedMEDICARE