Healthcare Provider Details

I. General information

NPI: 1316694979
Provider Name (Legal Business Name): JULIE CROASDILL SUDP-T, CPSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2499
US

IV. Provider business mailing address

325 9TH AVE
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-3119
  • Fax: 206-744-8632
Mailing address:
  • Phone: 206-845-9289
  • Fax: 206-744-8632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDPT.CO.70031305
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberCAAR.CG.70056581
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: