Provider Demographics
NPI:1023344124
Name:SIRIANNI, JULIA (OD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:SIRIANNI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15259 SE 82ND DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-6609
Mailing Address - Country:US
Mailing Address - Phone:503-657-0321
Mailing Address - Fax:503-657-7066
Practice Address - Street 1:15259 SE 82ND DR STE 101
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-6609
Practice Address - Country:US
Practice Address - Phone:503-657-0321
Practice Address - Fax:503-657-7066
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3416ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist