Provider Demographics
NPI:1851572762
Name:APPLEGATE, JULIE KAY (PHD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:KAY
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:PHD
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 643
Mailing Address - Street 2:
Mailing Address - City:DEPOE BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97341-0643
Mailing Address - Country:US
Mailing Address - Phone:541-921-7945
Mailing Address - Fax:
Practice Address - Street 1:116A N HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:DEPOE BAY
Practice Address - State:OR
Practice Address - Zip Code:97341-1947
Practice Address - Country:US
Practice Address - Phone:541-921-7945
Practice Address - Fax:541-614-4133
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5749103TC0700X
OR3066103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
54355AMedicare UPIN