Provider Demographics
NPI:1134876964
Name:HARTLEY, JULIE EILEEN (NPC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:EILEEN
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-4547
Mailing Address - Country:US
Mailing Address - Phone:541-889-8410
Mailing Address - Fax:541-889-8093
Practice Address - Street 1:335 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-4547
Practice Address - Country:US
Practice Address - Phone:541-889-8410
Practice Address - Fax:541-889-8093
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202202172NP-PP164W00000X, 363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care