Healthcare Provider Details

I. General information

NPI: 1609142843
Provider Name (Legal Business Name): JULIE MARIE TEA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIE TEA CONRAD M.D.

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY NE PO BOX 5371
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-7370
  • Fax:
Mailing address:
  • Phone: 206-987-7370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA128531
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60573479
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: