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1225054646

NPI Code Detail

MEDICARE: DR. KIRSTEN MARIE WINN CARR M.D.

MEDICARE: DR. KIRSTEN MARIE WINN CARR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	33275	AZ
2	207Q00000X	Family Medicine Physician	19947	HI
3	207Q00000X	Family Medicine Physician	MD606724	WA
4	207Q00000X	Family Medicine Physician	MD26408	OR

General Provider Information

NPI Number	:	1225054646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRSTEN MARIE WINN CARR M.D.

Provider Business Mailing Address
First Line	:	5252 SW IDAHO ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97221-1617
Country	:	US
Telephone Number	:	503-740-6693
Fax Number	:	503-379-0944

Provider Business Practice Location Address
First Line	:	1675 SW MARLOW AVE STE 202
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97225-5102
Country	:	US
Telephone Number	:	503-430-1777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	12/28/2021

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Directions to “ DR. KIRSTEN MARIE WINN CARR M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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