Healthcare Provider Details

I. General information

NPI: 1497949457
Provider Name (Legal Business Name): JULIE A KAHNAMOUI ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 05/18/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 ELLIS ST
BELLINGHAM WA
98225-1904
US

IV. Provider business mailing address

PO BOX 5127
EVERETT WA
98206-5127
US

V. Phone/Fax

Practice location:
  • Phone: 360-734-4404
  • Fax: 360-734-7409
Mailing address:
  • Phone: 360-752-2956
  • Fax: 360-734-7409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60020696
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberAP 60020696
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: