Provider Demographics
NPI:1285643569
Name:GRAFF, JULIE DEEANNE (RD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:DEEANNE
Last Name:GRAFF
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3532 LANYARD DR NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-1307
Mailing Address - Country:US
Mailing Address - Phone:253-968-1450
Mailing Address - Fax:
Practice Address - Street 1:MADIGAN ARMY MEDICAL CENTER NCD
Practice Address - Street 2:9040 REID ST
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD327133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered