Healthcare Provider Details

I. General information

NPI: 1831379247
Provider Name (Legal Business Name): DONNA JEAN WINTER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 NE 58TH AVE
PORTLAND OR
97213-3663
US

IV. Provider business mailing address

1607 NE 58TH AVE
PORTLAND OR
97213-3663
US

V. Phone/Fax

Practice location:
  • Phone: 503-493-2988
  • Fax:
Mailing address:
  • Phone: 503-493-2988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: