Healthcare Provider Details

I. General information

NPI: 1821242264
Provider Name (Legal Business Name): JULIE ANN JOHNSON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2008
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 PORTLAND RD
NEWBERG OR
97132-1847
US

IV. Provider business mailing address

30300 SW BOONES FERRY RD
WILSONVILLE OR
97070-6889
US

V. Phone/Fax

Practice location:
  • Phone: 503-538-9360
  • Fax: 503-538-9261
Mailing address:
  • Phone: 503-570-3533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10392
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number10392
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: