Provider Demographics
NPI:1538556949
Name:WINDLER, DAVID WAYNE (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:WAYNE
Last Name:WINDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1498 SE TECH CENTER PL STE 240
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5508
Mailing Address - Country:US
Mailing Address - Phone:360-597-1313
Mailing Address - Fax:360-597-1413
Practice Address - Street 1:12123 SW 69TH AVE
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8514
Practice Address - Country:US
Practice Address - Phone:971-708-7600
Practice Address - Fax:971-371-5230
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ORMD200967207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program