Provider Demographics
NPI:1336411636
Name:WINDER, DONALD EDWIN JR (PA)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:EDWIN
Last Name:WINDER
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:2480 LIBERTY ST NE
Mailing Address - Street 2:#110
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-8380
Mailing Address - Country:US
Mailing Address - Phone:503-371-1010
Mailing Address - Fax:503-371-0805
Practice Address - Street 1:2480 LIBERTY ST NE
Practice Address - Street 2:#110
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-8380
Practice Address - Country:US
Practice Address - Phone:503-371-1010
Practice Address - Fax:503-371-0805
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2013-03-27
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Provider Licenses
StateLicense IDTaxonomies
ORPA156714363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical