Healthcare Provider Details

I. General information

NPI: 1073565305
Provider Name (Legal Business Name): JULIETTE MARIE POWER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 02/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 MERIDIAN DR
WOODBURN OR
97071-9668
US

IV. Provider business mailing address

2400 LANCASTER DR NE KAISER PERMANENTE
SALEM OR
97305-1221
US

V. Phone/Fax

Practice location:
  • Phone: 503-982-2174
  • Fax: 503-982-4599
Mailing address:
  • Phone: 503-982-2174
  • Fax: 503-982-4599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD23304
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: