Provider Demographics
NPI:1558514521
Name:WILLIAMSON, JULIA ANN (LMP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 W VALLEY HWY
Mailing Address - Street 2:TRLR #50
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-3621
Mailing Address - Country:US
Mailing Address - Phone:360-584-0412
Mailing Address - Fax:253-277-0765
Practice Address - Street 1:827 W VALLEY HWY
Practice Address - Street 2:TRLR #50
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-3621
Practice Address - Country:US
Practice Address - Phone:360-584-0412
Practice Address - Fax:253-277-0765
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60025108225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist