Healthcare Provider Details

I. General information

NPI: 1720931215
Provider Name (Legal Business Name): MR. JULIAN CHRISTOPHER MEILLEUR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC STREET; BOX 357134
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

1959 NE PACIFIC STREET; BOX 357134
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 504-952-2138
  • Fax:
Mailing address:
  • Phone: 504-952-2138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number70102083
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: