Provider Demographics
NPI:1801699160
Name:GUERCIA, JULIET AUTUMN (NP)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:AUTUMN
Last Name:GUERCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 WESTGATE
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-9606
Mailing Address - Country:US
Mailing Address - Phone:509-521-6093
Mailing Address - Fax:
Practice Address - Street 1:2500 WESTGATE
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-9606
Practice Address - Country:US
Practice Address - Phone:509-521-6093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10021145363LP0808X
WAAP61681818363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner