Healthcare Provider Details

I. General information

NPI: 1356969315
Provider Name (Legal Business Name): JULIA KATHLEEN ESCOBAR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ANNEX SECOND FLOOR BLDG 9900
TACOMA WA
98431-5930
US

IV. Provider business mailing address

5001 N MESA ST APT 1304
EL PASO TX
79912-5930
US

V. Phone/Fax

Practice location:
  • Phone: 323-918-9868
  • Fax:
Mailing address:
  • Phone: 720-841-4466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE61291666
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: