Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD00028155 | WA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD13554 | OR |
NPI | 1043203086 |
---|---|
Provider Name | Thomas Robin Winkler |
First Address | Portland, OR 97232-2684 |
Second Address | Salem, OR 97301-3975 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 26/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
042643 | (05) | OR |
8155715 | (05) | WA |
F08482 | (02) | OR |