Healthcare Provider Details

I. General information

NPI: 1801699160
Provider Name (Legal Business Name): JULIET AUTUMN GUERCIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 WESTGATE
PENDLETON OR
97801-9606
US

IV. Provider business mailing address

2500 WESTGATE
PENDLETON OR
97801-9606
US

V. Phone/Fax

Practice location:
  • Phone: 509-521-6093
  • Fax:
Mailing address:
  • Phone: 509-521-6093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10021145
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61681818
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: