Healthcare Provider Details

I. General information

NPI: 1831595727
Provider Name (Legal Business Name): JULEA LYNN LEITER BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 09/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 REDMOND WAY SUITE #205
REDMOND WA
98052-3862
US

IV. Provider business mailing address

1808 RICHARDS RD STE 102
BELLEVUE WA
98005-3982
US

V. Phone/Fax

Practice location:
  • Phone: 425-242-0973
  • Fax: 425-650-6916
Mailing address:
  • Phone: 425-754-5135
  • Fax: 425-650-6916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: