Basic Information
| Provider Information | |||||||||
| NPI: | 1265895650 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WINTERS | ||||||||
| FirstName: | ELLIOT | ||||||||
| MiddleName: | ESTES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 NE 87TH AVE STE 210 | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986641988 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608285396 | ||||||||
| FaxNumber: | 3608285455 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 NE MOTHER JOSEPH PL | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986643200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605142000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2016 | ||||||||
| LastUpdateDate: | 06/04/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | DO198385 | OR | N | Allopathic & Osteopathic Physicians | Anesthesiology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207L00000X | OP61027282 | WA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.