MEDICARE: JULIE ANN KROHN

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1942835616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANN KROHN

Provider Business Mailing Address
First Line	:	610 STILLWELL AVE
Second Line	:
City	:	TILLAMOOK
State	:	OR
Zip	:	97141-3752
Country	:	US
Telephone Number	:	503-842-9622
Fax Number	:

Provider Business Practice Location Address
First Line	:	34600 CAPE KIWANDA DR
Second Line	:
City	:	PACIFIC CITY
State	:	OR
Zip	:	97135-8020
Country	:	US
Telephone Number	:	503-965-7900
Fax Number	:

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

Provider Enumeration Date	:	03/03/2020
Last Update Date	:	03/03/2020

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