Provider Demographics
NPI:1073565305
Name:POWER, JULIETTE MARIE (MD)
Entity Type:Individual
Prefix:MS
First Name:JULIETTE
Middle Name:MARIE
Last Name:POWER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2400 LANCASTER DR NE
Mailing Address - Street 2:KAISER PERMANENTE
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1221
Mailing Address - Country:US
Mailing Address - Phone:503-982-2174
Mailing Address - Fax:503-982-4599
Practice Address - Street 1:1390 MERIDIAN DR
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-9668
Practice Address - Country:US
Practice Address - Phone:503-982-2174
Practice Address - Fax:503-982-4599
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23304207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287241Medicaid
OR110277Medicare ID - Type Unspecified
ORH46721Medicare UPIN