Provider Demographics
NPI:1780202184
Name:BOWMAN, JULIE ANNE (LMT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:BOWMAN
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 1:3333 REDWOOD AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1159
Mailing Address - Country:US
Mailing Address - Phone:360-961-1402
Mailing Address - Fax:
Practice Address - Street 1:1229 CORNWALL AVE STE 204
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5023
Practice Address - Country:US
Practice Address - Phone:360-820-0334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-12
Last Update Date:2020-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60546260225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist