Provider Demographics
NPI:1265871255
Name:WARNOCK, JULIE NYOKA (CRNA)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:NYOKA
Last Name:WARNOCK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:NYOKA
Other - Last Name:FARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21402 S PARKVIEW LN
Mailing Address - Street 2:
Mailing Address - City:ESTACADA
Mailing Address - State:OR
Mailing Address - Zip Code:97023-9603
Mailing Address - Country:US
Mailing Address - Phone:503-348-9499
Mailing Address - Fax:
Practice Address - Street 1:10180 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-8970
Practice Address - Country:US
Practice Address - Phone:503-652-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-23
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201360036CRNA367500000X
WAAP60368961367500000X
MTNUR-APRN-LIC-197691367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered