Healthcare Provider Details

I. General information

NPI: 1114866829
Provider Name (Legal Business Name): JULIE MARIE ALLEN BARBOUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21730 BOONES BOROUGH DR
BEND OR
97701-8820
US

IV. Provider business mailing address

21730 BOONES BOROUGH DR
BEND OR
97701-8820
US

V. Phone/Fax

Practice location:
  • Phone: 541-390-2912
  • Fax: 541-208-6700
Mailing address:
  • Phone: 541-390-2912
  • Fax: 541-209-6700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number093003329RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: