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General NPI Number Information
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NPI Number | 1558587170
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Entity Type | Organization
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Legal Business Name | WINANS PLLC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 872 SUSSEX AVE E
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City | TENINO
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State | WA
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Zip | 98589-9287
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Country | US
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Telephone | 360-264-2353
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 734
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City | TENINO
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State | WA
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Zip | 98589-0734
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Country | US
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Telephone | 360-264-2353
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Fax |
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Authorized Official
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Title or Position | OWNER PARTNER
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Name | SUZANNE KLUH WINANS
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Credential | DDS
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Telephone | 360-264-2353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9980
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License Number State | WA
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