Dr Gary R Winebrenner, PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

CH00034321 Issued in WA

Legal business name

DR GARY R WINEBRENNER, PC

Doing business as

Healthy Life Clinic

Practice address

406 SE 131St Ave
Suite 109
Vancouver, WA 98683-4004

Phone

(360) 213-0021

Fax

(360) 213-1269

NPI assigned

Jan 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gary Robert Winebrenner, D.C.

Title

President

Phone

(360) 213-0021

Specialties & licenses 1

Addresses

Other names 1

• Healthy Life Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1831374719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 SE 131ST AVE",
            "address_2": "SUITE 109",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834004",
            "telephone_number": "360-213-0021",
            "fax_number": "360-213-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SE 131ST AVE",
            "address_2": "SUITE 109",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834004",
            "telephone_number": "360-213-0021",
            "fax_number": "360-213-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR GARY R WINEBRENNER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "WINEBRENNER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-213-0021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WA",
            "license": "CH00034321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Life Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Service Clinic/Center in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Health Service Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.