MEDICARE: DR. DEBORAH LEE WINER PH.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	103TC0700X	Clinical Psychologist	534	OR

General Provider Information

NPI Number	:	1396850129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH LEE WINER PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 1726
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97075-1726
Country	:	US
Telephone Number	:	503-627-9056
Fax Number	:	503-627-0917

Provider Business Practice Location Address
First Line	:	10700 S.W. BEAVERTON-HILLSDALE HIGHWAY
Second Line	:	SUITE 500
City	:	BEAVERTON
State	:	OR
Zip	:	97005-3037
Country	:	US
Telephone Number	:	503-627-9056
Fax Number	:	503-627-0917

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/14/2013

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