Provider Demographics
NPI:1275820938
Name:LERWICK, JULIE LAURA (PHD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LAURA
Last Name:LERWICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:LERWICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 82819
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97282-0819
Mailing Address - Country:US
Mailing Address - Phone:503-659-5515
Mailing Address - Fax:
Practice Address - Street 1:890 82ND DR
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-1803
Practice Address - Country:US
Practice Address - Phone:503-659-5515
Practice Address - Fax:503-212-2292
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health