Provider Demographics
NPI:1396850129
Name:WINER, DEBORAH LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LEE
Last Name:WINER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:L
Other - Last Name:WINER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 1726
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97075-1726
Mailing Address - Country:US
Mailing Address - Phone:503-627-9056
Mailing Address - Fax:503-627-0917
Practice Address - Street 1:10700 S.W. BEAVERTON-HILLSDALE HIGHWAY
Practice Address - Street 2:SUITE 500
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3037
Practice Address - Country:US
Practice Address - Phone:503-627-9056
Practice Address - Fax:503-627-0917
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2013-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR534103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical