Healthcare Provider Details

I. General information

NPI: 1962787655
Provider Name (Legal Business Name): JULIA ELIZABETH MCLAWSEN PH.D., R.PSYCH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 112TH AVE SE STE 100
BELLEVUE WA
98004
US

IV. Provider business mailing address

317 109TH AVE SE
BELLEVUE WA
98004-6342
US

V. Phone/Fax

Practice location:
  • Phone: 206-289-0456
  • Fax: 888-573-8472
Mailing address:
  • Phone: 206-289-0456
  • Fax: 888-573-8472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number60249064
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPY60249064
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: