Provider Demographics
NPI:1932215621
Name:FLORES, JULIANNA MARIE (CERTIFIED)
Entity Type:Individual
Prefix:MRS
First Name:JULIANNA
Middle Name:MARIE
Last Name:FLORES
Suffix:
Gender:F
Credentials:CERTIFIED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:SCOTTS MILLS
Mailing Address - State:OR
Mailing Address - Zip Code:97375-0108
Mailing Address - Country:US
Mailing Address - Phone:503-873-0807
Mailing Address - Fax:
Practice Address - Street 1:12100 SE STEVENS CT
Practice Address - Street 2:STE 106
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-8707
Practice Address - Country:US
Practice Address - Phone:503-653-1442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician