Healthcare Provider Details

I. General information

NPI: 1093148223
Provider Name (Legal Business Name): MRS. JULIE L ROESKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JULIE L FRANCIS

II. Dates (important events)

Enumeration Date: 08/12/2013
Last Update Date: 09/29/2026
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1234
SAINT HELENS OR
97051-8234
US

IV. Provider business mailing address

PO BOX 1234
SAINT HELENS OR
97051-8234
US

V. Phone/Fax

Practice location:
  • Phone: 503-397-5211
  • Fax: 503-397-5373
Mailing address:
  • Phone: 503-397-5211
  • Fax: 503-397-5373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number108927
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: