Provider Demographics
NPI:1346610680
Name:CHANDLER, JULIET
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24050 SE STARK ST APT 502
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3167
Mailing Address - Country:US
Mailing Address - Phone:503-405-0851
Mailing Address - Fax:
Practice Address - Street 1:24050 SE STARK ST APT 502
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3167
Practice Address - Country:US
Practice Address - Phone:503-405-0851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor