Individual
JULIE ANN IDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16807 SE KINGSRIDGE CT, PORTLAND, OR 97267-5268
(503) 380-8547
Mailing address
16807 SE KINGSRIDGE CT, PORTLAND, OR 97267-5268
(503) 380-8547
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
—
—
Other
Enumeration date
02/09/2010
Last updated
02/09/2010
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