Provider Demographics
NPI:1003027780
Name:VISSER, JULIA J (DPT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:J
Last Name:VISSER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 359920
Mailing Address - Street 2:325 NINTH AVENUE
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2499
Mailing Address - Country:US
Mailing Address - Phone:206-744-1675
Mailing Address - Fax:206-744-1664
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:BOX 359920
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-1675
Practice Address - Fax:206-744-1664
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009961225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8865422Medicare PIN