Healthcare Provider Details

I. General information

NPI: 1740903343
Provider Name (Legal Business Name): JULIE MARIE VONMOSS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIE MARIE VONMOSS MS, CCC-SLP

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 WINTERSAGE CIR UNIT A
TALENT OR
97540-9537
US

IV. Provider business mailing address

221 WINTERSAGE CIR UNIT A
TALENT OR
97540-9537
US

V. Phone/Fax

Practice location:
  • Phone: 541-690-8194
  • Fax: 541-702-0019
Mailing address:
  • Phone: 541-690-8194
  • Fax: 541-702-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number016349
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: