MEDICARE: ERIN LEE WINTERTON LMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MA00016384	WA

General Provider Information

NPI Number	:	1528213923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN LEE WINTERTON LMP

Provider Business Mailing Address
First Line	:	8308 E MILL PLAIN BLVD
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98664-2066
Country	:	US
Telephone Number	:	360-694-1118
Fax Number	:	360-694-1979

Provider Business Practice Location Address
First Line	:	8308 E MILL PLAIN BLVD
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98664-2066
Country	:	US
Telephone Number	:	360-694-1118
Fax Number	:	360-694-1979

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2008
Last Update Date	:	11/26/2008

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