{
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"OrgName": "JULIA BISHOP-TALL LLC",
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"Credential": null,
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"FirstLineMailingAddress": "14925 SW BARROWS RD.",
"SecondLineMailingAddress": "STE 109 #137",
"MailingAddressCityName": "BEAVERTON",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97007-7565",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-966-5660",
"MailingAddressFaxNumber": "503-713-5770",
"FirstLinePracticeLocationAddress": "14523 WESTLAKE DR STE 25",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAKE OSWEGO",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97035-7700",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-966-5660",
"PracticeLocationAddressFaxNumber": "503-713-5770",
"EnumerationDate": "07/30/2018",
"LastUpdateDate": "08/11/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BISHOP-TALL",
"AuthorizedOfficialFirstName": "JULIA",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DNP, PMHNP-BC",
"AuthorizedOfficialTelephoneNumber": "206-697-0843",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}