Healthcare Provider Details

I. General information

NPI: 1508955998
Provider Name (Legal Business Name): JULIE A HAUGEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 COBURG RD STE 100
EUGENE OR
97401-7479
US

IV. Provider business mailing address

10 COBURG RD STE 100
EUGENE OR
97401-7479
US

V. Phone/Fax

Practice location:
  • Phone: 541-342-8616
  • Fax: 541-686-4814
Mailing address:
  • Phone: 541-342-8616
  • Fax: 541-686-4814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD20766
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD20766
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMD20766
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: