Individual
JULIE CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3640 NW SAMARITAN DR STE 100, CORVALLIS, OR 97330-3738
(541) 768-5205
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3403
OR
103T00000X
Psychologist
PS018413
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/11/2015
Last updated
10/19/2021
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