Individual
JULIA ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17882 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-6103
(503) 353-9415
Mailing address
17882 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-6103
(503) 353-9415
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
OR-10042-M
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292910
—
OR
Enumeration date
04/11/2016
Last updated
04/11/2016
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