Provider Demographics
NPI:1982714879
Name:WINDE, JAMES WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WARREN
Last Name:WINDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46314 TIMINE WAY
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-9417
Mailing Address - Country:US
Mailing Address - Phone:541-966-9830
Mailing Address - Fax:541-240-8751
Practice Address - Street 1:46314 TIMINE WAY
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-9417
Practice Address - Country:US
Practice Address - Phone:541-966-9830
Practice Address - Fax:541-240-8751
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20809174400000X, 207RS0012X
WAMD60020421207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR150729Medicaid
ORP00229051OtherMEDICARE RAILROAD
ORF97948Medicare UPIN
WAG8928665Medicare PIN
ORR147771Medicare PIN