Provider Demographics
NPI:1265788350
Name:WINKEL, JASON ROBERT (LMT)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:ROBERT
Last Name:WINKEL
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 PATTERSON ST STE 3-A
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3619
Mailing Address - Country:US
Mailing Address - Phone:541-505-8180
Mailing Address - Fax:
Practice Address - Street 1:1180 PATTERSON ST STE 3-A
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3619
Practice Address - Country:US
Practice Address - Phone:541-505-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-26
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13267225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist