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Individual

JULIA MORTLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ND, LAC

Contact information

Practice address
16904 SE 1ST ST, VANCOUVER, WA 98684-8511
(541) 979-6467
Mailing address
7121 SW 29TH AVE, PORTLAND, OR 97219-1907
(541) 979-6467

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC164766
OR
171100000X
Acupuncturist
AC60416884
WA
175F00000X
Naturopath
2012
OR
175F00000X
Naturopath
Primary
NT60416820
WA

Other

Enumeration date
11/07/2013
Last updated
09/26/2015
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