Provider Demographics
NPI:1023150828
Name:HAMILTON, JULIE KAY (LAC, RN)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:KAY
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LAC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MARIETTA ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5031
Mailing Address - Country:US
Mailing Address - Phone:503-585-0665
Mailing Address - Fax:503-585-0665
Practice Address - Street 1:120 MARIETTA ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5031
Practice Address - Country:US
Practice Address - Phone:503-585-0665
Practice Address - Fax:503-585-0665
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00568171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist