Provider Demographics
NPI:1386722510
Name:WEBER, JAMES KARL (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KARL
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NW MARKET ST STE 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3909
Mailing Address - Country:US
Mailing Address - Phone:206-782-7441
Mailing Address - Fax:206-784-9664
Practice Address - Street 1:1801 NW MARKET ST STE 301
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3909
Practice Address - Country:US
Practice Address - Phone:206-782-7441
Practice Address - Fax:206-784-9664
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00016228174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1552009Medicaid
WA1552009Medicaid