Provider Demographics
NPI:1962411967
Name:HUNT, JULIA (CCC-A)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2698 NE COURTNEY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7637
Mailing Address - Country:US
Mailing Address - Phone:541-389-6669
Mailing Address - Fax:541-389-8865
Practice Address - Street 1:2698 NE COURTNEY DR STE 100
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7637
Practice Address - Country:US
Practice Address - Phone:541-389-6669
Practice Address - Fax:541-389-8865
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR21612231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR038195Medicaid
OR116625Medicare ID - Type UnspecifiedMEDICARE