Provider Demographics
NPI:1407083264
Name:WINTER, NEVA JOLETA (LMT)
Entity Type:Individual
Prefix:
First Name:NEVA
Middle Name:JOLETA
Last Name:WINTER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-6871
Mailing Address - Country:US
Mailing Address - Phone:503-484-7565
Mailing Address - Fax:
Practice Address - Street 1:4004 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-6871
Practice Address - Country:US
Practice Address - Phone:503-484-7565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14997172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist