Healthcare Provider Details

I. General information

NPI: 1407067556
Provider Name (Legal Business Name): JULIE NICOLE CHEVILLET D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 GEORGIANA ST
PORT ANGELES WA
98362-3911
US

IV. Provider business mailing address

PO BOX 24029
SEATTLE WA
98124-0029
US

V. Phone/Fax

Practice location:
  • Phone: 360-565-0999
  • Fax: 360-457-1599
Mailing address:
  • Phone: 360-565-0999
  • Fax: 360-457-1599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDO.OP.61481464
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberDO.OP.61481464
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: