Provider Demographics
NPI:1518174812
Name:MCCUTCHEON, JULIA WINN (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:WINN
Last Name:MCCUTCHEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 A ST
Mailing Address - Street 2:SUITE 1, PMB 46
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1947
Mailing Address - Country:US
Mailing Address - Phone:541-414-7974
Mailing Address - Fax:
Practice Address - Street 1:208 OAK ST
Practice Address - Street 2:SUITE 106-C
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1871
Practice Address - Country:US
Practice Address - Phone:541-414-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC350882084P0800X
CO407012084P0800X
OR1674412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F30467Medicare UPIN
NC5919103Medicaid