Provider Demographics
NPI:1235388299
Name:AMUNDSON, JULIE K (LMHC, LMP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:AMUNDSON
Suffix:
Gender:F
Credentials:LMHC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19812 DAYTON AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3417
Mailing Address - Country:US
Mailing Address - Phone:206-778-0654
Mailing Address - Fax:
Practice Address - Street 1:555 DAYTON ST STE D
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3476
Practice Address - Country:US
Practice Address - Phone:206-778-0654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 7641225700000X
WALH 00005042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist