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Individual

DR. WINONA J. FIRTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
840 A ST, SPRINGFIELD, OR 97477-4710
(541) 746-8401
(541) 746-8402
Mailing address
PO BOX 76, SPRINGFIELD, OR 97477-0004
(541) 746-8401
(541) 746-8402

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2194ATI
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011342000
BLUE CROSS BLUE SHIELD
OR
05
020839
OR
01
02805-01
PACIFIC SOURCE
OR
01
800678
PROVIDENCE
OR
Enumeration date
05/23/2005
Last updated
10/29/2007
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