Healthcare Provider Details

I. General information

NPI: 1982714879
Provider Name (Legal Business Name): JAMES WARREN WINDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46314 TIMINE WAY
PENDLETON OR
97801-9417
US

IV. Provider business mailing address

46314 TIMINE WAY
PENDLETON OR
97801-9417
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-9830
  • Fax: 541-240-8751
Mailing address:
  • Phone: 541-966-9830
  • Fax: 541-240-8751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD20809
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberMD20809
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60020421
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: