Provider Demographics
NPI:1134518368
Name:MERCER, JULIE ANN (MED)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:MERCER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-0031
Mailing Address - Country:US
Mailing Address - Phone:541-967-3819
Mailing Address - Fax:541-967-7259
Practice Address - Street 1:104 4TH AVE SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2804
Practice Address - Country:US
Practice Address - Phone:541-967-3819
Practice Address - Fax:541-967-7259
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR936002305Medicaid