MEDICARE: REBECCA JANE WINNICK

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	225700000X	Massage Therapist	28276	OR

General Provider Information

NPI Number	:	1457082653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA JANE WINNICK

Provider Business Mailing Address
First Line	:	1020 SE 7TH AVE UNIT 14100
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97293-0815
Country	:	US
Telephone Number	:	971-314-0970
Fax Number	:

Provider Business Practice Location Address
First Line	:	1016 SE 12TH AVE # 7
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-2513
Country	:	US
Telephone Number	:	971-314-0970
Fax Number	:

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

Provider Enumeration Date	:	06/20/2022
Last Update Date	:	03/11/2026

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Directions to “ REBECCA JANE WINNICK ” Practice Location

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