Healthcare Provider Details

I. General information

NPI: 1356625388
Provider Name (Legal Business Name): JULIE PEERBOOM BROOKRESON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE M PEERBOOM

II. Dates (important events)

Enumeration Date: 10/10/2011
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 YAKIMA AVE STE 203
TACOMA WA
98405-5300
US

IV. Provider business mailing address

1708 YAKIMA AVE STE 203
TACOMA WA
98405-5300
US

V. Phone/Fax

Practice location:
  • Phone: 253-382-8150
  • Fax: 253-382-8155
Mailing address:
  • Phone: 253-382-8150
  • Fax: 253-382-8155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60238469
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: