Healthcare Provider Details

I. General information

NPI: 1306499215
Provider Name (Legal Business Name): JULIE MCCARTNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2019
Last Update Date: 09/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7610 40TH ST W STE 20
UNIVERSITY PLACE WA
98466
US

IV. Provider business mailing address

7610 40TH ST W STE 200
UNIVERSITY PLACE WA
98466-3838
US

V. Phone/Fax

Practice location:
  • Phone: 253-507-7231
  • Fax:
Mailing address:
  • Phone: 253-507-7231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: