Provider Demographics
NPI:1093094971
Name:SIMON, JULIE M
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:SIMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:M
Other - Last Name:O'HARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:311 S L ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3720
Mailing Address - Country:US
Mailing Address - Phone:253-403-3473
Mailing Address - Fax:
Practice Address - Street 1:311 S L ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-3720
Practice Address - Country:US
Practice Address - Phone:253-403-3473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS