Provider Demographics
NPI:1083841878
Name:SIEPMANN, JULIE C (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:SIEPMANN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 SE CEDARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-0216
Mailing Address - Country:US
Mailing Address - Phone:503-435-1550
Mailing Address - Fax:
Practice Address - Street 1:1075 SE CEDARWOOD AVE
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-0216
Practice Address - Country:US
Practice Address - Phone:503-435-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL29931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR520276000OtherREGENCE BLUE CROSS BLUE SHIELD OF OREGON