Healthcare Provider Details

I. General information

NPI: 1518164219
Provider Name (Legal Business Name): JULIE ANNE OSTERLING PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 01/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BOREN AVE N
SEATTLE WA
98109-5337
US

IV. Provider business mailing address

400 BOREN AVE N
SEATTLE WA
98109-5337
US

V. Phone/Fax

Practice location:
  • Phone: 206-332-1646
  • Fax:
Mailing address:
  • Phone: 206-332-1646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY00002359
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY00002359
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY00002359
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPY00002359
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: