Provider Demographics
NPI:1356682975
Name:VALENTINE, JULIA (LMT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 SE KING RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-2538
Mailing Address - Country:US
Mailing Address - Phone:503-788-3800
Mailing Address - Fax:503-788-8020
Practice Address - Street 1:6501 SE KING RD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-2538
Practice Address - Country:US
Practice Address - Phone:503-788-3800
Practice Address - Fax:503-788-8020
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19554225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist