Provider Demographics
NPI:1902831811
Name:WEIGHALL, STEVEN L (MD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:L
Last Name:WEIGHALL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 2300
Mailing Address - Street 2:MSC 1025 COLUMBIA BASIN IMAGING PC
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-2300
Mailing Address - Country:US
Mailing Address - Phone:509-943-5616
Mailing Address - Fax:509-943-9272
Practice Address - Street 1:888 SWIFT BLVD
Practice Address - Street 2:#3A COLUMBIA BASIN IMAGING PC
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-943-5616
Practice Address - Fax:509-943-9272
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD000217682085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8625303Medicaid
WA7038102Medicaid
OR291906Medicaid
OR291906Medicaid