MEDICARE: MS. JULIANNA WATERS L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	L002149	OR
2	1041C0700X	Clinical Social Worker	2049	OR

General Provider Information

NPI Number	:	1831124866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIANNA WATERS L.C.S.W.

Provider Business Mailing Address
First Line	:	2932 EUGENE ST
Second Line	:
City	:	HOOD RIVER
State	:	OR
Zip	:	97031-2089
Country	:	US
Telephone Number	:	503-225-0908
Fax Number	:

Provider Business Practice Location Address
First Line	:	2932 EUGENE ST
Second Line	:
City	:	HOOD RIVER
State	:	OR
Zip	:	97031-2089
Country	:	US
Telephone Number	:	503-225-0908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	04/02/2024

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Directions to “ MS. JULIANNA WATERS L.C.S.W.” Practice Location

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