Healthcare Provider Details

I. General information

NPI: 1053799197
Provider Name (Legal Business Name): JULIA SELANDER NOREIKA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE BOX 359859
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

325 9TH AVE BOX 359859
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-2140
  • Fax: 206-744-6046
Mailing address:
  • Phone: 206-744-2140
  • Fax: 206-744-6046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT60523445
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: