Healthcare Provider Details

I. General information

NPI: 1720306749
Provider Name (Legal Business Name): JULIE BEERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE YEO

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 N NORTHWOOD CENTER CT STE B
COEUR D ALENE ID
83814-4944
US

IV. Provider business mailing address

100 DENNIS ST SW STE B
TUMWATER WA
98501-6523
US

V. Phone/Fax

Practice location:
  • Phone: 208-665-7055
  • Fax: 509-466-4407
Mailing address:
  • Phone: 360-338-0181
  • Fax: 360-338-0257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT60139432
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: