Provider Demographics
NPI:1013190917
Name:PATRICIA J WINN MD
Entity Type:Organization
Organization Name:PATRICIA J WINN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WINN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-278-1348
Mailing Address - Street 1:411 SE 14TH ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-3207
Mailing Address - Country:US
Mailing Address - Phone:541-278-1348
Mailing Address - Fax:
Practice Address - Street 1:411 SE 14TH ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3207
Practice Address - Country:US
Practice Address - Phone:541-278-1348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR107666OtherMEDICARE GROUP