Provider Demographics
NPI:1346222932
Name:VANNI, JULIE A (DPT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:VANNI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 WALLINGFORD AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8218
Mailing Address - Country:US
Mailing Address - Phone:206-829-8269
Mailing Address - Fax:206-829-8594
Practice Address - Street 1:3727 CALIFORNIA AVE SW 1A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4303
Practice Address - Country:US
Practice Address - Phone:206-938-0860
Practice Address - Fax:206-938-0866
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000097842251S0007X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
11481575OtherCAQH
WA2104352Medicaid
WA0198452OtherLABOR & INDUSTRIES