MEDICARE: JULIA K BOWMAN MS RD LMHC

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
1	133V00000X	Registered Dietitian	DI0001584	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9647TA	OTHER	WA	BLUE SHIELD #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831224229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA K BOWMAN MS RD LMHC

Provider Business Mailing Address
First Line	:	164 TENNESSEE AVE NE APT 2
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-6475
Country	:	US
Telephone Number	:	206-790-3898
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 JEFFERSON DAVIS HWY
Second Line	:	SUITE 211
City	:	ARLINGTON
State	:	VA
Zip	:	22202-3603
Country	:	US
Telephone Number	:	571-257-3378
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	03/13/2012

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