Provider Demographics
NPI:1578564415
Name:MARKHAM, JULIET K (MD)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:K
Last Name:MARKHAM
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:PO BOX 1438
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0350
Mailing Address - Country:US
Mailing Address - Phone:541-278-3377
Mailing Address - Fax:541-278-2434
Practice Address - Street 1:27SWFRAZER AVE
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-2147
Practice Address - Country:US
Practice Address - Phone:541-278-3377
Practice Address - Fax:541-278-2434
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28773207V00000X
ORMD26356207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G65303Medicare UPIN