Provider Demographics
NPI:1790260966
Name:PLUMB, JULIE ANN (CDPT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:PLUMB
Suffix:
Gender:F
Credentials:CDPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:729 PROSPECT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-5330
Mailing Address - Country:US
Mailing Address - Phone:360-895-1307
Mailing Address - Fax:360-895-4805
Practice Address - Street 1:729 PROSPECT ST STE 200
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-5330
Practice Address - Country:US
Practice Address - Phone:360-895-1307
Practice Address - Fax:360-895-4805
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACO60655804OtherCHEMICAL DEPENDENCY COUNSELOR / AFFILIATED COUNSELOR