Active NPI
Maureen Connor Weatherspoon, EFDA
- Dental Assistant
- Aloha, OR
National Provider Identifier
1457464711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 7712
- Practice address
- 21345 SW Alexander St
Aloha, OR 97006-1710 - Phone
- (503) 642-4922
- NPI assigned
- Aug 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 7712 | OR | Primary |
Addresses
Primary practice location
21345 SW Alexander St
Aloha, OR 97006-1710
Mailing address
21345 SW Alexander St
Aloha, OR 97006-1710
Phone (503) 642-4922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7712 | OR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457464711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21345 SW ALEXANDER ST",
"city": "ALOHA",
"state": "OR",
"postal_code": "970061710",
"telephone_number": "503-642-4922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21345 SW ALEXANDER ST",
"city": "ALOHA",
"state": "OR",
"postal_code": "970061710",
"telephone_number": "503-642-4922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEATHERSPOON",
"first_name": "MAUREEN",
"middle_name": "CONNOR",
"name_prefix": "Mrs.",
"credential": "EFDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "OR",
"license": "7712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aloha, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.