MEDICARE: MS. JULIE CHRISTINE COLAW PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT00007734	WA
2	225100000X	Physical Therapist	NC00006636	NC

General Provider Information

NPI Number	:	1114123551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIE CHRISTINE COLAW PT

Provider Business Mailing Address
First Line	:	1120 BAYENES CT SE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98513-7726
Country	:	US
Telephone Number	:	360-790-8202
Fax Number	:	360-455-1714

Provider Business Practice Location Address
First Line	:	4001 CAPITOL MALL DR SW
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-8657
Country	:	US
Telephone Number	:	360-754-9792
Fax Number	:	360-754-0627

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	07/08/2007

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