Individual
JULIANA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
625 NE GALLOWAY ST, MCMINNVILLE, OR 97128-3933
(541) 908-1200
Mailing address
625 NE GALLOWAY ST, MCMINNVILLE, OR 97128-3933
(503) 474-3705
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OR
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/06/2016
Last updated
07/15/2026
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