Provider Demographics
NPI:1598979213
Name:MICHAELSON, JULIUS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIUS
Middle Name:
Last Name:MICHAELSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 S MERIDIAN
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-7590
Mailing Address - Country:US
Mailing Address - Phone:253-697-2453
Mailing Address - Fax:253-845-3768
Practice Address - Street 1:1703 S MERIDIAN
Practice Address - Street 2:SUITE 301
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-7590
Practice Address - Country:US
Practice Address - Phone:253-697-2453
Practice Address - Fax:253-845-3768
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031843207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1088277Medicaid
WA115000255Medicare PIN
WAB624-65Medicare UPIN