Provider Demographics
NPI:1912207820
Name:GOELZER, JULIANNE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:
Last Name:GOELZER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SW CENTURY DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1189
Mailing Address - Country:US
Mailing Address - Phone:541-389-7184
Mailing Address - Fax:541-389-7282
Practice Address - Street 1:320 SW CENTURY DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1189
Practice Address - Country:US
Practice Address - Phone:541-389-7184
Practice Address - Fax:541-389-7282
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8620183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist