Provider Demographics
NPI:1447212329
Name:HANFLING, JULIA ANNE (RD, CDE)
Entity Type:Individual
Prefix:MR
First Name:JULIA
Middle Name:ANNE
Last Name:HANFLING
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:ANNE
Other - Last Name:HANFLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2229 SE MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4866
Mailing Address - Country:US
Mailing Address - Phone:503-413-2750
Mailing Address - Fax:503-413-2735
Practice Address - Street 1:2800 N VANCOUVER AVE
Practice Address - Street 2:LEGACY EMANUEL DIABETES CLINIC, SUITE 231
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1630
Practice Address - Country:US
Practice Address - Phone:503-413-2750
Practice Address - Fax:503-413-2735
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR460133V00000X
OR10208672133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORN/AMedicaid
OR114227Medicare ID - Type Unspecified
ORN/AMedicaid