Healthcare Provider Details

I. General information

NPI: 1316430523
Provider Name (Legal Business Name): JULIA VICTORIA BANDE SALVE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5197 NW LOWER RIVER RD BLDG 1
VANCOUVER WA
98660-1013
US

IV. Provider business mailing address

16191 SE GOOSEHOLLOW DR
DAMASCUS OR
97089-7887
US

V. Phone/Fax

Practice location:
  • Phone: 360-205-1222
  • Fax:
Mailing address:
  • Phone: 971-259-3515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number201703445NP-PP
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201703445NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: