Provider Demographics
NPI:1548748825
Name:JULIA BISHOP-TALL LLC
Entity Type:Organization
Organization Name:JULIA BISHOP-TALL LLC
Other - Org Name:COUNTERBALANCE PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BISHOP-TALL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC
Authorized Official - Phone:206-697-0843
Mailing Address - Street 1:14925 SW BARROWS RD.
Mailing Address - Street 2:STE 109 #137
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-7565
Mailing Address - Country:US
Mailing Address - Phone:503-966-5660
Mailing Address - Fax:503-713-5770
Practice Address - Street 1:14523 WESTLAKE DR STE 25
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-7700
Practice Address - Country:US
Practice Address - Phone:503-966-5660
Practice Address - Fax:503-713-5770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty