Provider Demographics
NPI:1609881085
Name:CAPP, JULIET A (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:A
Last Name:CAPP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JULIET
Other - Middle Name:
Other - Last Name:ACOB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3800 SUMMITVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2715
Mailing Address - Country:US
Mailing Address - Phone:509-972-1259
Mailing Address - Fax:509-972-1258
Practice Address - Street 1:120 S. 72ND AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-4200
Practice Address - Country:US
Practice Address - Phone:509-972-1259
Practice Address - Fax:509-972-1258
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003556363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9614280Medicaid
G8800126Medicare PIN
S83755Medicare UPIN