Basic Information
| Provider Information | |||||||||
| NPI: | 1174042824 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHANEY | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | STUDENT FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1475 MOUNT HOOD AVE | ||||||||
| Address2: | |||||||||
| City: | WOODBURN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970719066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034921021 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1475 MOUNT HOOD AVE | ||||||||
| Address2: | |||||||||
| City: | WOODBURN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970719066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9719835360 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 201901501NP-PP | OR | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | 201901501NP-PP | OR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.