Provider Demographics
NPI:1871628297
Name:EVANS, JULIE B (MS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:B
Last Name:EVANS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:1343 A MONMOUTH ST
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97351-0248
Mailing Address - Country:US
Mailing Address - Phone:503-838-3001
Mailing Address - Fax:503-838-0994
Practice Address - Street 1:1861 NW KINGS BLVD
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-0000
Practice Address - Country:US
Practice Address - Phone:541-757-2500
Practice Address - Fax:541-757-3001
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20625231H00000X
ORHAS-P-657098237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist