Healthcare Provider Details

I. General information

NPI: 1902004393
Provider Name (Legal Business Name): JULIE K TERRY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE K KING MD

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 SQUALICUM PKWY STE 140
BELLINGHAM WA
98225-1906
US

IV. Provider business mailing address

1115 SE 164TH AVE DEPT 358
VANCOUVER WA
98683-8004
US

V. Phone/Fax

Practice location:
  • Phone: 360-788-8420
  • Fax: 360-788-6852
Mailing address:
  • Phone: 360-729-1462
  • Fax: 360-729-3104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60479487
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: