MEDICARE: JULIE ROSE PETERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	016328	OR

General Provider Information

NPI Number	:	1417811761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ROSE PETERS

Provider Business Mailing Address
First Line	:	6960 SW SANDBURG ST
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-8039
Country	:	US
Telephone Number	:	503-431-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	14850 SW 132ND TER
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97224-6118
Country	:	US
Telephone Number	:	503-431-4900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ JULIE ROSE PETERS ” Practice Location

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