Individual ProviderJulia Lorraine GulliksonCounselorBehavioral Health & Social Service ProvidersPractice Address10373 NE Hancock St Ste 200, Portland, OR 97220-3873(503) 253-6754PECOS EnrollmentBased on the most recent information from CMS, provider Julia Lorraine Gullikson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1629858105Provider TypeIndividualFull NameGullikson, Julia LorraineGenderFemaleSole ProprietorNoEnumeration Date10/3/2023Last Updated10/3/2023Contact InformationPractice LocationPractice Address10373 NE Hancock St Ste 200, Portland, OR 97220-3873Phone(503) 253-6754FaxUnlisted FaxMailing LocationMailing AddressPO Box 8459, Portland, OR 97207-8459PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer