Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Julie Kolstad Clark

Individual provider Denturist · NPI 1609589837

Julie Kolstad Clark is a Denturist in Roseburg, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2023

Practice location Address checks out

150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042
Phone: (541) 672-9596
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Denturist (primary) Taxonomy 122400000X · Licence DT-TMP-10228509 (OR)

Record details

NPI number1609589837
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 3, 2023
Last updated in NPPESJanuary 3, 2023
Certification dateJanuary 3, 2023
Mailing address847 Se Blakeley Ave, Roseburg, OR 97470-4828

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