Healthcare Provider Details

I. General information

NPI: 1295094522
Provider Name (Legal Business Name): DAVID WINSTON SANT LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 02/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 17TH ST
OREGON CITY OR
97045-1032
US

IV. Provider business mailing address

309 17TH ST
OREGON CITY OR
97045-1032
US

V. Phone/Fax

Practice location:
  • Phone: 503-260-0969
  • Fax:
Mailing address:
  • Phone: 503-260-0969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL6297
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: