Provider Demographics
NPI:1619159548
Name:MURRAY, JULIE LYN (LMT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:LYN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12616 SE 276 TH PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030
Mailing Address - Country:US
Mailing Address - Phone:253-631-1832
Mailing Address - Fax:
Practice Address - Street 1:29034 216TH AVE SE
Practice Address - Street 2:
Practice Address - City:BLACK DIAMOND
Practice Address - State:WA
Practice Address - Zip Code:98010-1297
Practice Address - Country:US
Practice Address - Phone:360-886-2649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMAOOOO6144225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist