Provider Demographics
NPI:1215391818
Name:WOOD, JULIANNA (LMT)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 SW VIEW CREST DR
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:OR
Mailing Address - Zip Code:97115-9564
Mailing Address - Country:US
Mailing Address - Phone:503-575-5894
Mailing Address - Fax:
Practice Address - Street 1:999 SW VIEW CREST DR
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:OR
Practice Address - Zip Code:97115-9564
Practice Address - Country:US
Practice Address - Phone:503-575-5894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-09
Last Update Date:2016-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22020225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist