Provider Demographics
NPI:1558792465
Name:HALE, JULIE MELISSA (BSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MELISSA
Last Name:HALE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MELISSA
Other - Last Name:CONDIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2640 NW ALEXANDRA AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-1289
Mailing Address - Country:US
Mailing Address - Phone:503-239-1248
Mailing Address - Fax:503-239-1252
Practice Address - Street 1:2640 NW ALEXANDRA AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-1289
Practice Address - Country:US
Practice Address - Phone:503-239-1248
Practice Address - Fax:503-239-1252
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor