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General NPI Number Information
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NPI Number | 1952162554
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Entity Type | Organization
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Legal Business Name | WINTER WELLNESS LLC
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 2542 NE COURTNEY DR STE 108
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City | BEND
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State | OR
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Zip | 97701-7685
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Country | US
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Telephone | 559-462-0161
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Fax | 866-461-6780
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Provider Business Mailing Address
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Address Line | 2032 NW GREENWOOD PL
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City | REDMOND
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State | OR
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Zip | 97756-8813
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Country | US
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Telephone | 559-972-0096
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KELLY ANNE WINTER
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Credential | LMFT
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Telephone | 559-462-0161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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