Individual
JULIETTE MICHELLE DEPHILIPPIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
97825 SHOPPING CENTER AVE, BROOKINGS, OR 97415-9403
(541) 412-9800
(541) 412-9600
Mailing address
PO BOX 2742, BROOKINGS, OR 97415-0326
(858) 222-9404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA226542
OR
Other
Enumeration date
02/03/2025
Last updated
01/05/2026
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