Provider Demographics
NPI:1790803500
Name:RAZ, JULIE (LMT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:RAZ
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 1:6900 CHURCH CREEK LOOP NW
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-5914
Mailing Address - Country:US
Mailing Address - Phone:360-572-4603
Mailing Address - Fax:360-403-3070
Practice Address - Street 1:437 N OLYMPIC AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1299
Practice Address - Country:US
Practice Address - Phone:360-403-3075
Practice Address - Fax:360-403-3070
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA14669174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist