Provider Demographics
NPI:1386701522
Name:JU, WINIFRED CHIN-TEH (PHD)
Entity type:Individual
Prefix:DR
First Name:WINIFRED
Middle Name:CHIN-TEH
Last Name:JU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3836 SUNSET HILLS DR SE
Mailing Address - Street 2:
Mailing Address - City:TURNER
Mailing Address - State:OR
Mailing Address - Zip Code:97392-9550
Mailing Address - Country:US
Mailing Address - Phone:505-400-4309
Mailing Address - Fax:
Practice Address - Street 1:780 COMMERCIAL ST SE
Practice Address - Street 2:STE 304
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3462
Practice Address - Country:US
Practice Address - Phone:503-365-0045
Practice Address - Fax:503-365-9590
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1598103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities