JULIE KOLSTAD CLARK NPI 1609589837

NPI Information

NPI: 1609589837
Provider Name: JULIE KOLSTAD CLARK
Classification: Denturist - 122400000X
Entity Type: Individual
Address:
150 NE KENNETH FORD DR
ROSEBURG, OR
ZIP 97470
Phone: (541) 672-9596
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Julie Kolstad Clark is a denturist in Roseburg, OR. The provider is a denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices. Julie Kolstad Clark NPI is 1609589837. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

150 NE KENNETH FORD DR
ROSEBURG, OR
ZIP 97470-042
Phone: (541) 672-9596

The enumeration date for this NPI number is 1/3/2023 and was last updated on 1/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122400000X	Denturist		DT-TMP-10228509	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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