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Individual

MS. JULIANN ADELE SQUIRES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, LMT

Contact information

Practice address
3615 NE GRAND AVE, PORTLAND, OR 97212-2104
(503) 281-0787
Mailing address
2840 SE 31ST AVE, PORTLAND, OR 97202-1408
(503) 447-6879

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C11420
OR
101YM0800X
Mental Health Counselor
225700000X
Massage Therapist
14582
OR
225700000X
Massage Therapist
Primary
15482
OR

Other

Enumeration date
11/11/2015
Last updated
05/04/2026
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