Healthcare Provider Details

I. General information

NPI: 1992761183
Provider Name (Legal Business Name): JULIA LEE CHARMAYNE PULLIAM PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 JOHN ADAMS ST
OREGON CITY OR
97045-1609
US

IV. Provider business mailing address

PO BOX 1517
PENDLETON OR
97801-0410
US

V. Phone/Fax

Practice location:
  • Phone: 503-656-1484
  • Fax: 503-650-1976
Mailing address:
  • Phone: 877-708-1119
  • Fax: 541-278-8349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA01081
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: