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Contact Information

WYNN STREET LLC
10445 SW CANYON RD STE 114
BEAVERTON, OR97005-1913
 Phone: 971-303-9360
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist/Technologist, Other

246Z00000X
 

Technician, Other

247200000X 75 Slide Preparation Facility
Indicates primary specialty

NPI Profile & details for WYNN STREET LLC

NPI Number 1730902941
LBN Legal business name WYNN STREET LLC
Authorized official JODI TURNER - (OWNER/MANAGER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 11/05/2024
Last updated 05/13/2026 - About 3 weeks ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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