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Individual

JULIE M. PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
30 NE MLK JR BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
(503) 232-3854
Mailing address
30 NE MLK JR BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
(503) 232-3854

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00138549
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201403887NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP60559831
WA

Other

Enumeration date
07/02/2014
Last updated
10/24/2025
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