Provider Demographics
NPI:1629510813
Name:HIPP, JULIA PORTWOOD (ND)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:PORTWOOD
Last Name:HIPP
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 LARRABEE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7367
Mailing Address - Country:US
Mailing Address - Phone:360-296-9267
Mailing Address - Fax:888-746-2736
Practice Address - Street 1:1050 LARRABEE AVE STE 202
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7367
Practice Address - Country:US
Practice Address - Phone:360-296-9267
Practice Address - Fax:888-746-2736
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-05
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60687026175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA20161208233843Medicaid