Provider Demographics
NPI:1346340155
Name:CZARTOSKI, JULIE LIDA COOPER (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LIDA COOPER
Last Name:CZARTOSKI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:LIDA
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:325 9TH AVE
Mailing Address - Street 2:BOX 359927
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2420
Mailing Address - Country:US
Mailing Address - Phone:206-744-5100
Mailing Address - Fax:206-667-2299
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-5100
Practice Address - Fax:206-667-2299
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006928363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9650466Medicaid
WA0213181OtherL&I PIN
WA03329UOtherREGENCE PIN
Q71912Medicare UPIN
WA9650466Medicaid