Provider Demographics
NPI:1053981548
Name:OCONNOR, JULIANNE M (CNS)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:M
Last Name:OCONNOR
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2547 NE 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-3609
Mailing Address - Country:US
Mailing Address - Phone:503-729-9931
Mailing Address - Fax:
Practice Address - Street 1:555 SE MLK BLVD STE 2051
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2120
Practice Address - Country:US
Practice Address - Phone:503-729-9931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education