Basic Information
| Provider Information | |||||||||
| NPI: | 1265662134 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMISCH | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2298 | ||||||||
| Address2: | |||||||||
| City: | CORVALLIS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973392298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055704160 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 260 SW MADISON AVE STE 107 | ||||||||
| Address2: | |||||||||
| City: | CORVALLIS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973334728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415571892 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2009 | ||||||||
| LastUpdateDate: | 03/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 4101006414 | MI | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 166.000892 | IL | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | T1160 | OR | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.