Provider Demographics
NPI:1598451668
Name:WINDSOR, SIERRA MATTEA
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:MATTEA
Last Name:WINDSOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 NW 23RD AVE APT 504
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2065
Mailing Address - Country:US
Mailing Address - Phone:541-490-0115
Mailing Address - Fax:
Practice Address - Street 1:7455 SW BEVELAND RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-8610
Practice Address - Country:US
Practice Address - Phone:503-894-9118
Practice Address - Fax:503-894-7398
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist