Provider Demographics
NPI:1184216079
Name:GEARHEARD COLINDRES, JULILA MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:JULILA
Middle Name:MARIE
Last Name:GEARHEARD COLINDRES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JEWEL
Other - Middle Name:
Other - Last Name:COLINDRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:621 SE 155TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-3144
Mailing Address - Country:US
Mailing Address - Phone:503-754-0383
Mailing Address - Fax:
Practice Address - Street 1:2507 CHRISTIE DRIVE
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034
Practice Address - Country:US
Practice Address - Phone:503-635-3416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health