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Individual

JULIA HAVRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9155 SW BARNES RD STE 440, PORTLAND, OR 97225-6631
(503) 935-8500
(503) 935-8505
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA202569
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500792553
OR
Enumeration date
02/18/2020
Last updated
11/22/2023
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