Provider Demographics
NPI:1083855126
Name:NUNN, JULIA (LMT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:NUNN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 NW LOVEJOY ST
Mailing Address - Street 2:SOLACE THERAPEUTICS #107
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2346
Mailing Address - Country:US
Mailing Address - Phone:503-957-9996
Mailing Address - Fax:888-311-5554
Practice Address - Street 1:1720 NW LOVEJOY ST
Practice Address - Street 2:SOLACE THERAPEUTICS #107
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2346
Practice Address - Country:US
Practice Address - Phone:503-957-9996
Practice Address - Fax:888-311-5554
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLMT#8215225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist