Healthcare Provider Details

I. General information

NPI: 1861803330
Provider Name (Legal Business Name): AUBREY WINN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2014
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 NE MARY ROSE PL STE 201
BEND OR
97701-7133
US

IV. Provider business mailing address

2450 NE MARY ROSE PL STE 201
BEND OR
97701-7133
US

V. Phone/Fax

Practice location:
  • Phone: 541-585-7546
  • Fax: 541-582-7177
Mailing address:
  • Phone: 541-585-7546
  • Fax: 541-582-7177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberA178569
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberMD61422430
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD61422430
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number231151
License Number StateOR
# 5
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number231151
License Number StateOR
# 6
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number231151
License Number StateOR
# 7
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA178569
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: