Provider Demographics
NPI:1801239884
Name:WILBER, JULIA EVELYN (DC)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:EVELYN
Last Name:WILBER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8885 SW CANYON RD STE 203
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-3431
Mailing Address - Country:US
Mailing Address - Phone:971-255-1708
Mailing Address - Fax:503-719-5615
Practice Address - Street 1:8885 SW CANYON RD STE 203
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-3431
Practice Address - Country:US
Practice Address - Phone:971-255-1708
Practice Address - Fax:503-719-5615
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500683151Medicaid