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General NPI Number Information
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NPI Number | 1114050101
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Entity Type | Individual
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Provider Name | JULIE ANNE LOUGH LMP
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 13000 BEVERLY PARK RD SUITE K
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City | MUKILTEO
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State | WA
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Zip | 98275-5849
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Country | US
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Telephone | 425-344-5571
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Fax |
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Provider Business Mailing Address
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Address Line | 19421 81ST PL W
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City | EDMONDS
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State | WA
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Zip | 98026-6223
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Country | US
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Telephone | 425-344-5571
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Fax | 425-673-7918
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00012318
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License Number State | WA
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