Provider Demographics
NPI:1811164536
Name:PALMER, JULIE ANNE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:PALMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25117 SW PARKWAY AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9697
Mailing Address - Country:US
Mailing Address - Phone:888-757-3422
Mailing Address - Fax:866-616-2415
Practice Address - Street 1:8170 SW VLAHOS DR
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-6620
Practice Address - Country:US
Practice Address - Phone:503-570-8833
Practice Address - Fax:503-682-3493
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6354225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist