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General NPI Number Information
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NPI Number | 1174680920
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Entity Type | Individual
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Provider Name | JULIE ELLEN FOSTER FNP
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 03/13/2009
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Provider Practice Location Address
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Address Line | 12050 SE HOLGATE BLVD
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City | PORTLAND
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State | OR
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Zip | 97266-2160
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Country | US
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Telephone | 503-793-3875
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Fax |
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Provider Business Mailing Address
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Address Line | 10837 SE HAPPY VALLEY DR
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City | HAPPY VALLEY
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State | OR
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Zip | 97236-6074
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Country | US
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Telephone | 503-698-4901
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200150144NP-FNP-PP
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License Number State | OR
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