Provider Demographics
NPI:1679630875
Name:HEIMAN, JULIA R
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:R
Last Name:HEIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UWMC-ROOSEVELT
Practice Address - Street 2:4225 ROOSEVELT WAY NE, SUITE 306
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4794
Practice Address - Country:US
Practice Address - Phone:206-598-7792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00000773103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
8102OtherINTERNAL ID-MOTOR VEHICLE ID
WA8397903Medicaid
R34187Medicare UPIN
102189Medicare ID - Type Unspecified