Provider Demographics
NPI:1376810390
Name:REYNOLDS, JULIE KAY (PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:KAY
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:KAY
Other - Last Name:SARVELA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:914 S SCHEUBER ROAD
Mailing Address - Street 2:PROVIDENCE CENTRALIA HOSPITAL
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98532
Mailing Address - Country:US
Mailing Address - Phone:360-330-8720
Mailing Address - Fax:360-330-8737
Practice Address - Street 1:914 S SCHEUBER ROAD
Practice Address - Street 2:PROVIDENCE CENTRALIA HOSPITAL
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98532
Practice Address - Country:US
Practice Address - Phone:360-330-8720
Practice Address - Fax:360-330-8737
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006123225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist