Provider Demographics
NPI:1518590538
Name:IGARTA, JULIE KAY (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:KAY
Last Name:IGARTA
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:KAY
Other - Last Name:TOBEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2815 NW UPSHUR ST. APT. A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210
Mailing Address - Country:US
Mailing Address - Phone:805-748-6210
Mailing Address - Fax:
Practice Address - Street 1:140 NORTHWEST 14TH AVENUE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209
Practice Address - Country:US
Practice Address - Phone:503-771-1883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR099000392RN163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant