1811913981 NPI number — MRS. JULIE LURA HOGEN PHHNP

Table of content: MRS. JULIE LURA HOGEN PHHNP (NPI 1811913981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811913981 NPI number — MRS. JULIE LURA HOGEN PHHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOGEN
Provider First Name:
JULIE
Provider Middle Name:
LURA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811913981
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6950 SW HAMPTON ST
Provider Second Line Business Mailing Address:
STE 109
Provider Business Mailing Address City Name:
TIGARD
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97223-8330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-620-3200
Provider Business Mailing Address Fax Number:
503-684-8226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6950 SW HAMPTON ST
Provider Second Line Business Practice Location Address:
STE 109
Provider Business Practice Location Address City Name:
TIGARD
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97223-8330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-620-3200
Provider Business Practice Location Address Fax Number:
503-684-8226
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 360494 . This is a "ANCC" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




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