Provider Demographics
NPI:1275971053
Name:JULIA, MARITZA
Entity Type:Individual
Prefix:MS
First Name:MARITZA
Middle Name:
Last Name:JULIA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARITZA
Other - Middle Name:
Other - Last Name:JULIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:2913 5TH AVE NE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-6748
Mailing Address - Country:US
Mailing Address - Phone:855-255-1750
Mailing Address - Fax:855-255-0905
Practice Address - Street 1:2913 5TH AVE NE
Practice Address - Street 2:SUITE 101
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-6748
Practice Address - Country:US
Practice Address - Phone:855-255-1750
Practice Address - Fax:855-255-0905
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60335953363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner