Provider Demographics
NPI:1497992416
Name:LUTZ, JULIE C (RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:LUTZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 RUCKER AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-5418
Mailing Address - Country:US
Mailing Address - Phone:425-339-8668
Mailing Address - Fax:
Practice Address - Street 1:3020 RUCKER AVE STE 100
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3900
Practice Address - Country:US
Practice Address - Phone:425-339-8668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00112902163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse