Provider Demographics
NPI:1780708412
Name:WELLER, JANET E (COF, CMF)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:E
Last Name:WELLER
Suffix:
Gender:F
Credentials:COF, CMF
Other - Prefix:MISS
Other - First Name:JANET
Other - Middle Name:E
Other - Last Name:CLEMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COF, CMF
Mailing Address - Street 1:1901 S CEDAR ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2308
Mailing Address - Country:US
Mailing Address - Phone:253-572-1282
Mailing Address - Fax:253-572-1175
Practice Address - Street 1:34709 9TH AVE S
Practice Address - Street 2:STE A-100
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8722
Practice Address - Country:US
Practice Address - Phone:253-952-3887
Practice Address - Fax:253-927-3058
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy Fitter
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter