Provider Demographics
NPI:1821467879
Name:WINKLER, EDITH (CSWA)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:
Last Name:WINKLER
Suffix:
Gender:F
Credentials:CSWA
Other - Prefix:
Other - First Name:EDITH
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2355 STATE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4541
Mailing Address - Country:US
Mailing Address - Phone:617-291-2509
Mailing Address - Fax:
Practice Address - Street 1:234 NW SEBLAR DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-1028
Practice Address - Country:US
Practice Address - Phone:617-291-2509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA131231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical