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General NPI Number Information
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NPI Number | 1275006033
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Entity Type | Individual
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Provider Name | GAOJUA JULIET PENTON
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Gender | Female
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 406 BLACK HILLS LN SW STE A
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City | OLYMPIA
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State | WA
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Zip | 98502-8144
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Country | US
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Telephone | 360-754-1735
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Fax |
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Provider Business Mailing Address
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Address Line | 406 BLACK HILLS LN SW STE A
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City | OLYMPIA
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State | WA
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Zip | 98502-8144
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Country | US
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Telephone | 360-754-1735
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP.AP.61206341-NP
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License Number State | WA
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