Provider Demographics
NPI:1952162554
Name:WINTER WELLNESS LLC
Entity Type:Organization
Organization Name:WINTER WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-462-0161
Mailing Address - Street 1:2032 NW GREENWOOD PL
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-8813
Mailing Address - Country:US
Mailing Address - Phone:559-972-0096
Mailing Address - Fax:
Practice Address - Street 1:376 SW BLUFF DR STE 2
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1399
Practice Address - Country:US
Practice Address - Phone:559-462-0161
Practice Address - Fax:866-461-6780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty