Provider Demographics
NPI:1285700526
Name:WINGER, LORRAINE MARY (OD)
Entity type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:MARY
Last Name:WINGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 NW WALL ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2715
Mailing Address - Country:US
Mailing Address - Phone:541-382-4756
Mailing Address - Fax:541-382-4455
Practice Address - Street 1:822 NW WALL ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2715
Practice Address - Country:US
Practice Address - Phone:541-382-4756
Practice Address - Fax:541-382-4455
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1833-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist