Healthcare Provider Details

I. General information

NPI: 1598326878
Provider Name (Legal Business Name): JULINA ANN SKOW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 S HOWARD ST STE 310
SPOKANE WA
99201-4421
US

IV. Provider business mailing address

2525 E 53RD AVE APT E108
SPOKANE WA
99223-9146
US

V. Phone/Fax

Practice location:
  • Phone: 800-781-5536
  • Fax:
Mailing address:
  • Phone: 574-584-4003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-67485
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberAB61350561
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: