Provider Demographics
NPI:1447014121
Name:BENNION, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:BENNION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 SW HAMPTON ST STE 310
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8332
Mailing Address - Country:US
Mailing Address - Phone:971-301-2041
Mailing Address - Fax:
Practice Address - Street 1:6950 SW HAMPTON ST STE 310
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8332
Practice Address - Country:US
Practice Address - Phone:971-301-2041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR8818106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist