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General NPI Number Information
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NPI Number | 1780086025
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Entity Type | Individual
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Provider Name | JULIE LALENA GRIESS CNA
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Gender | Female
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 2964 NE DOUGLAS AVE
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City | ROSEBURG
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State | OR
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Zip | 97470-3726
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Country | US
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Telephone | 541-680-2008
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Fax |
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Provider Business Mailing Address
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Address Line | 2964 NE DOUGLAS AVE
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City | ROSEBURG
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State | OR
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Zip | 97470-3726
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Country | US
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Telephone | 541-680-2008
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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 | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number | 261QP0904X
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number | 261QV0200X
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 314000000X
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License Number State | OR
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