Provider Demographics
NPI:1093025918
Name:CRAMER, JULIE LYN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:LYN
Last Name:CRAMER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CENTERPOINTE DR STE 600
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8662
Mailing Address - Country:US
Mailing Address - Phone:541-969-7466
Mailing Address - Fax:855-529-7962
Practice Address - Street 1:5 CENTERPOINTE DR STE 600
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8662
Practice Address - Country:US
Practice Address - Phone:541-969-7466
Practice Address - Fax:855-529-7962
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA153184363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500629132Medicaid