Provider Demographics
NPI:1184647398
Name:GLASS, JULIE (ND)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:GLASS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 COMMERCIAL ST SE
Mailing Address - Street 2:#100
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302
Mailing Address - Country:US
Mailing Address - Phone:971-283-7100
Mailing Address - Fax:888-849-3103
Practice Address - Street 1:1995 COMMERCIAL ST SE
Practice Address - Street 2:#100
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302
Practice Address - Country:US
Practice Address - Phone:971-283-7100
Practice Address - Fax:888-849-3103
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR960175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath