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NPI Code Detail

MEDICARE: JULEA ROSE IVANCOVICH

MEDICARE: JULEA ROSE IVANCOVICH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorWA

General Provider Information

NPI Number : 1063364511
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULEA ROSE IVANCOVICH
Provider Business Mailing Address
First Line : 1412 W CONNECTICUT ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-2320
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 BROADWAY
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-3036
Country : US
Telephone Number : 360-920-6977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “ JULEA ROSE IVANCOVICH ” Practice Location

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