Provider Demographics
NPI:1174680920
Name:FOSTER, JULIE ELLEN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ELLEN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10837 SE HAPPY VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97236-6074
Mailing Address - Country:US
Mailing Address - Phone:503-698-4901
Mailing Address - Fax:
Practice Address - Street 1:12050 SE HOLGATE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-2160
Practice Address - Country:US
Practice Address - Phone:503-793-3875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200150144NP-FNP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR141411Medicare PIN