Provider Demographics
NPI:1740562420
Name:WEAVER, COURTNEY MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:WEAVER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:MARIE
Other - Last Name:PLITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:7651 W MORNING CT
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-5650
Mailing Address - Country:US
Mailing Address - Phone:425-319-3992
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BOX 356165
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6165
Practice Address - Country:US
Practice Address - Phone:206-598-5637
Practice Address - Fax:206-598-2475
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAD60233492363LF0000X
ID62514363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily