Provider Demographics
NPI:1477289098
Name:OSBURNE, JULIE (PROF COUNSELOR ASSO)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:OSBURNE
Suffix:
Gender:F
Credentials:PROF COUNSELOR ASSO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 SW 10TH AVE STE 905
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2710
Mailing Address - Country:US
Mailing Address - Phone:503-446-2500
Mailing Address - Fax:
Practice Address - Street 1:511 SW 10TH AVE STE 905
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2710
Practice Address - Country:US
Practice Address - Phone:503-446-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR7634101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional