Provider Demographics
NPI:1720222839
Name:KRAINICK, JULIE L (DNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:KRAINICK
Suffix:
Gender:F
Credentials:DNP
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 249
Mailing Address - Street 2:
Mailing Address - City:HARRAH
Mailing Address - State:WA
Mailing Address - Zip Code:98933-0249
Mailing Address - Country:US
Mailing Address - Phone:509-952-3493
Mailing Address - Fax:
Practice Address - Street 1:918 E MEAD AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98903-3720
Practice Address - Country:US
Practice Address - Phone:509-453-1344
Practice Address - Fax:509-453-2209
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60025121163W00000X
WAAP60737777363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse