Provider Demographics
NPI:1790294494
Name:NELSON, JULIANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 W 4TH AVE APT E303
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-8549
Mailing Address - Country:US
Mailing Address - Phone:406-461-6337
Mailing Address - Fax:
Practice Address - Street 1:2800 W CLEARWATER AVE APT E303
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2945
Practice Address - Country:US
Practice Address - Phone:509-783-5412
Practice Address - Fax:406-461-6337
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60772116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist