Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 200050074NP | OR |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 200050074NP | OR |
NPI | 1669691119 |
---|---|
Provider Name | Lauri Winther |
First Address | Portland, OR 97208-3158 |
Second Address | Portland, OR 97213-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 23/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P14370 | (02) | OR |