Provider Demographics
NPI:1124391743
Name:JONES, JULIA LEE (RPH)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:LEE
Last Name:JONES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-3467
Mailing Address - Country:US
Mailing Address - Phone:541-963-9515
Mailing Address - Fax:541-963-8907
Practice Address - Street 1:71727 EVERS CANYON RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:OR
Practice Address - Zip Code:97827-8166
Practice Address - Country:US
Practice Address - Phone:541-437-1914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0007675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORRPH-0007675OtherSTATE PHARMACIST LICENSE