Provider Demographics
NPI:1659183200
Name:WEBER, ANTONIA (CSWA)
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:CSWA
Other - Prefix:
Other - First Name:TONIA
Other - Middle Name:
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CSWA
Mailing Address - Street 1:521 NE CADEN CT
Mailing Address - Street 2:
Mailing Address - City:ESTACADA
Mailing Address - State:OR
Mailing Address - Zip Code:97023-7454
Mailing Address - Country:US
Mailing Address - Phone:503-516-9395
Mailing Address - Fax:
Practice Address - Street 1:1511 DIVISION ST STE 102
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1589
Practice Address - Country:US
Practice Address - Phone:503-334-3035
Practice Address - Fax:503-961-9212
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA160461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical