Provider Demographics
NPI:1043340508
Name:WINTERS, JOHN (ND)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:WINTERS
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-2520
Mailing Address - Country:US
Mailing Address - Phone:541-963-7289
Mailing Address - Fax:541-963-7289
Practice Address - Street 1:1606 6TH ST
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-2520
Practice Address - Country:US
Practice Address - Phone:541-963-7289
Practice Address - Fax:541-963-7289
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0765175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath