Provider Demographics
NPI:1306374798
Name:WATERFIELD, JULIE ANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:WATERFIELD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANNE
Other - Last Name:MCRAE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2700 BRIDGEPORT WAY W STE D
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4600
Mailing Address - Country:US
Mailing Address - Phone:253-460-1879
Mailing Address - Fax:253-564-1412
Practice Address - Street 1:2700 BRIDGEPORT WAY W STE D
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4600
Practice Address - Country:US
Practice Address - Phone:253-460-1879
Practice Address - Fax:253-564-1412
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60735521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist